Healthcare Provider Details

I. General information

NPI: 1114969417
Provider Name (Legal Business Name): PARKER DRUG COMPANY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 04/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 N MAIN ST
FRANKLIN VA
23851-1752
US

IV. Provider business mailing address

PO BOX 617
FRANKLIN VA
23851-0617
US

V. Phone/Fax

Practice location:
  • Phone: 757-562-3333
  • Fax: 757-562-7620
Mailing address:
  • Phone: 757-562-3333
  • Fax: 757-562-7620

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number0201002758
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number0201002758
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: EDWARD CANADA
Title or Position: OWNER
Credential:
Phone: 757-562-3333