Healthcare Provider Details

I. General information

NPI: 1740214303
Provider Name (Legal Business Name): LESTERS PHARMACY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 12/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 SOUTH ST
FRONT ROYAL VA
22630-2220
US

IV. Provider business mailing address

20 SOUTH ST
FRONT ROYAL VA
22630-2220
US

V. Phone/Fax

Practice location:
  • Phone: 540-622-2307
  • Fax: 540-622-6445
Mailing address:
  • Phone: 540-622-2307
  • Fax: 540-622-6445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number0201003339
License Number StateVA

VIII. Authorized Official

Name: SCOTT LESTER
Title or Position: OWNER
Credential: RPH
Phone: 540-622-2307