Healthcare Provider Details

I. General information

NPI: 1982635900
Provider Name (Legal Business Name): DAWSON'S PHARMACY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 05/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2728 FAIRGROUND RD
GOOCHLAND VA
23063-3103
US

IV. Provider business mailing address

2728 FAIRGROUND RD
GOOCHLAND VA
23063-3103
US

V. Phone/Fax

Practice location:
  • Phone: 804-556-3311
  • Fax: 804-556-5520
Mailing address:
  • Phone: 804-556-3311
  • Fax: 804-556-5520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number0201004005
License Number StateVA

VIII. Authorized Official

Name: MR. VIRGIL WAYNE DAWSON II
Title or Position: OWNER
Credential: B.S.
Phone: 804-556-3311