Healthcare Provider Details

I. General information

NPI: 1629102926
Provider Name (Legal Business Name): PARTNERS PHARMACY OF VIRGINIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1746 E PARHAM RD
RICHMOND VA
23228-2202
US

IV. Provider business mailing address

50 LAWRENCE RD.
SPRINGFIELD NJ
07081-3121
US

V. Phone/Fax

Practice location:
  • Phone: 804-262-2500
  • Fax: 804-262-4800
Mailing address:
  • Phone: 908-931-9111
  • Fax: 908-931-9328

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number0201004141
License Number StateVA

VIII. Authorized Official

Name: JAY R PALIN
Title or Position: VP-PI
Credential:
Phone: 908-931-9111