Healthcare Provider Details

I. General information

NPI: 1346321007
Provider Name (Legal Business Name): FAMILY DISCOUNT PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

335 RIVERSIDE DR.
STANLEYTOWN VA
24168
US

IV. Provider business mailing address

335 RIVERSIDE DR. P.O. BOX 477
STANLEYTOWN VA
24168
US

V. Phone/Fax

Practice location:
  • Phone: 276-627-0536
  • Fax: 276-627-6074
Mailing address:
  • Phone: 276-627-0536
  • Fax: 276-627-6074

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number0201003494
License Number StateVA

VIII. Authorized Official

Name: JERRY R HARPER, JR
Title or Position: OWNER/CHIEF PHARMACIST
Credential:
Phone: 276-627-0536