Healthcare Provider Details

I. General information

NPI: 1114339959
Provider Name (Legal Business Name): DR. TERRY SINCLAIR HEALTH CLINIC, INC. PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2014
Last Update Date: 05/10/2021
Certification Date: 04/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 N CAMERON STREET. SUITE 100
WINCHESTER VA
22601
US

IV. Provider business mailing address

301 N. CAMERON STREET, SUITE 100
WINCHESTER VA
22601
US

V. Phone/Fax

Practice location:
  • Phone: 540-536-1680
  • Fax: 540-662-4724
Mailing address:
  • Phone: 540-536-1680
  • Fax: 540-662-4724

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number0201002404
License Number StateVA

VIII. Authorized Official

Name: KATRRINA R MCCLURE
Title or Position: EXECUTIVE DIRECTOR
Credential: MPH
Phone: 540-536-1681