Healthcare Provider Details

I. General information

NPI: 1215960323
Provider Name (Legal Business Name): HAMILTON PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16610 RUSSELL STREET
ST PAUL VA
24283
US

IV. Provider business mailing address

16610 RUSSELL STREET P.O. BOX 977
ST PAUL VA
24283
US

V. Phone/Fax

Practice location:
  • Phone: 276-762-9080
  • Fax: 276-762-9081
Mailing address:
  • Phone: 276-762-9080
  • Fax: 276-762-9081

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number0201004004
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number0201004004
License Number StateVA

VIII. Authorized Official

Name: DR. MICHAEL LAWRENCE HAMILTON
Title or Position: PRESIDENT , CO OWNER
Credential: PHARMD.
Phone: 276-762-9080