=====================================================
General NPI Number Information
=====================================================
NPI Number | 1033633474
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | YOUR PHARMACY INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/27/2017
-----------------------------------------------------
Last Update Date | 08/04/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 400 W GORDON AVE STE D
-----------------------------------------------------
City | GORDONSVILLE
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22942-7578
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 540-832-0000
-----------------------------------------------------
Fax | 540-832-3100
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 400 W GORDON AVE STE D
-----------------------------------------------------
City | GORDONSVILLE
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22942-7578
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 540-832-0000
-----------------------------------------------------
Fax | 540-832-3100
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHARMACIST/OWNER
-----------------------------------------------------
Name | JOHN WARREN SEYMOUR
-----------------------------------------------------
Credential | RPH
-----------------------------------------------------
Telephone | 540-661-7704
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 333600000X
-----------------------------------------------------
Taxonomy Name | Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | 0201004799
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------