MEDICARE: ANDERSON APOTHECARY LTD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy	0201004163	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4840066	OTHER	VA	NCPDP#
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1912109695
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANDERSON APOTHECARY LTD

Provider Business Mailing Address
First Line	:	1851 VIRGINIA AVENUE
Second Line	:
City	:	HARRISONBURG
State	:	VA
Zip	:	22802
Country	:	US
Telephone Number	:	540-434-7455
Fax Number	:

Provider Business Practice Location Address
First Line	:	1851 VIRGINIA AVENUE
Second Line	:
City	:	HARRISONBURG
State	:	VA
Zip	:	22802-8374
Country	:	US
Telephone Number	:	540-434-7455
Fax Number	:

Authorized Official
Title or Position	:	OWNER PHARMACIST
Name	:	MELVIN L ANDERSON
Credential	:	RPH
Telephone Number	:	540-434-7455

Provider Enumeration Date	:	06/04/2007
Last Update Date	:	03/07/2023

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