Healthcare Provider Details

I. General information

NPI: 1720370927
Provider Name (Legal Business Name): NORTHUMBERLAND PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2011
Last Update Date: 05/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6954 NORTHUMBERLAND HWY
HEATHSVILLE VA
22473-3335
US

IV. Provider business mailing address

PO BOX 1299
KILMARNOCK VA
22482-1299
US

V. Phone/Fax

Practice location:
  • Phone: 804-580-4940
  • Fax: 804-580-4942
Mailing address:
  • Phone: 804-435-8818
  • Fax: 804-435-8898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: CAROLL THROCKMORTON
Title or Position: OWNER
Credential:
Phone: 804-435-8818