Healthcare Provider Details

I. General information

NPI: 1326199324
Provider Name (Legal Business Name): FOUR WAY DRUG
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 03/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

FOUR WAY SHOPPING CENTER
NORTH TAZEWELL VA
24630
US

IV. Provider business mailing address

FOUR WAY SHOPPING CENTER P.O. BOX 730
NORTH TAZEWELL VA
24630
US

V. Phone/Fax

Practice location:
  • Phone: 276-988-6000
  • Fax: 276-988-3987
Mailing address:
  • Phone: 276-988-6000
  • Fax: 276-988-3987

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0201002839
License Number StateVA

VIII. Authorized Official

Name: MRS. JAMIE GREPIOTIS
Title or Position: OWNER, PRESIDENT, PIC
Credential: RPH
Phone: 276-988-6000