Healthcare Provider Details

I. General information

NPI: 1538235296
Provider Name (Legal Business Name): SCOTT COUNTY DRUG
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2006
Last Update Date: 08/31/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2834 US HWY 23 N
WEBER CITY VA
24290
US

IV. Provider business mailing address

2834 US HWY 23 N
WEBER CITY VA
24290
US

V. Phone/Fax

Practice location:
  • Phone: 276-386-3161
  • Fax: 276-386-3161
Mailing address:
  • Phone: 276-386-3161
  • Fax: 276-386-3161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MISS PATRICIA ANN NOE
Title or Position: PHARMACIST OWNER
Credential: BS PHARMACY
Phone: 276-386-3161