Healthcare Provider Details

I. General information

NPI: 1528035771
Provider Name (Legal Business Name): CHS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2006
Last Update Date: 06/30/2020
Certification Date: 06/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 CRYSTAL SPRING AVE SW SUITE 110 CARILION MEDICAL CENTER PHARMACY, INC
ROANOKE VA
24014
US

IV. Provider business mailing address

2001 CRYSTAL SPRING AVE SW SUITE 110 CARILION MEDICAL CENTER PHARMACY, INC
ROANOKE VA
24014
US

V. Phone/Fax

Practice location:
  • Phone: 540-853-0906
  • Fax: 540-853-0910
Mailing address:
  • Phone: 540-853-0906
  • Fax: 540-853-0910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number0201002117
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

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