Healthcare Provider Details

I. General information

NPI: 1265808166
Provider Name (Legal Business Name): CHS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2015
Last Update Date: 06/30/2020
Certification Date: 06/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

735 STEELES FORT RD STE B
RAPHINE VA
24472
US

IV. Provider business mailing address

2001 CRYSTAL SPRINGS AVE STE 110
ROANOKE VA
24014
US

V. Phone/Fax

Practice location:
  • Phone: 540-851-1760
  • Fax: 540-851-1765
Mailing address:
  • Phone: 540-266-6191
  • Fax: 540-853-0910

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 Number0201004668
License Number StateVA

VIII. Authorized Official

Name: ADRIAN S WILSON
Title or Position: DIRECTOR
Credential:
Phone: 540-266-6191