Healthcare Provider Details

I. General information

NPI: 1811517592
Provider Name (Legal Business Name): MARTINS PHARMACY OF DUBLIN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2020
Last Update Date: 03/02/2021
Certification Date: 03/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 BROAD ST
DUBLIN VA
24084
US

IV. Provider business mailing address

PO BOX 699
PULASKI VA
24301-0699
US

V. Phone/Fax

Practice location:
  • Phone: 540-518-7088
  • Fax: 540-307-5601
Mailing address:
  • Phone: 540-518-7088
  • Fax: 540-980-3784

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: ASHLEY WILLIAMS
Title or Position: PHARMACIST IN CHARGE
Credential: PHARM. D.
Phone: 540-518-7088