Healthcare Provider Details

I. General information

NPI: 1427139716
Provider Name (Legal Business Name): HARNESS HEALTH PHARMACY - VIRGINIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5801 BREMO RD FIRST FLOOR
RICHMOND VA
23226
US

IV. Provider business mailing address

5801 BREMO RD FL 1
RICHMOND VA
23226-1907
US

V. Phone/Fax

Practice location:
  • Phone: 804-281-8425
  • Fax: 804-287-7009
Mailing address:
  • Phone: 804-281-8425
  • Fax: 804-287-7009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number0201003011
License Number StateVA

VIII. Authorized Official

Name: KIMBERLY M RALSTON
Title or Position: VP REIMBURSEMENT
Credential:
Phone: 419-996-5119