Healthcare Provider Details

I. General information

NPI: 1033633474
Provider Name (Legal Business Name): YOUR PHARMACY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2017
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W GORDON AVE STE D
GORDONSVILLE VA
22942-7578
US

IV. Provider business mailing address

400 W GORDON AVE STE D
GORDONSVILLE VA
22942-7578
US

V. Phone/Fax

Practice location:
  • Phone: 540-832-0000
  • Fax: 540-832-3100
Mailing address:
  • Phone: 540-832-0000
  • Fax: 540-832-3100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number0201004799
License Number StateVA

VIII. Authorized Official

Name: JOHN WARREN SEYMOUR
Title or Position: PHARMACIST/OWNER
Credential: RPH
Phone: 540-661-7704