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General NPI Number Information
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NPI Number | 1063685535
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Entity Type | Organization
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Legal Business Name | VIRGINIA VETERANS CARE CENTER PHARMACY
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Dates
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Enumeration Date | 04/07/2008
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 4550 SHENANDOAH AVE NW
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City | ROANOKE
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State | VA
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Zip | 24017-4749
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Country | US
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Telephone | 540-982-2860
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Fax | 540-345-5701
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Provider Business Mailing Address
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Address Line | 4550 SHENANDOAH AVE NW
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City | ROANOKE
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State | VA
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Zip | 24017-4749
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Country | US
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Telephone | 540-982-2860
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Fax | 540-345-5701
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | WILLIAM VANTHIEL
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Credential |
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Telephone | 540-982-2860
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 0201003706
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License Number State | VA
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