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General NPI Number Information
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NPI Number | 1053456087
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Entity Type | Organization
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Legal Business Name | VICTORIA DRUG COMPANY
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1821 MAIN STREET
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City | VICTORIA
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State | VA
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Zip | 23974
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Country | US
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Telephone | 434-696-3343
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Fax | 434-696-2418
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Provider Business Mailing Address
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Address Line | 1821 MAIN STREET P.O. BOX AG
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City | VICTORIA
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State | VA
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Zip | 23974
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Country | US
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Telephone | 434-696-3343
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Fax | 434-696-2418
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | CLARENCE HALL
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Credential |
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Telephone | 434-696-3343
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 0201000837
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License Number State | VA
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