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General NPI Number Information
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NPI Number | 1083745509
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Entity Type | Organization
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Legal Business Name | CENTRAL VIRGINIA PHARMACY CONSULTANTS, P.C.
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 10/03/2023
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Provider Practice Location Address
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Address Line | 22776 TIMBERLAKE RD APT D
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City | LYNCHBURG
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State | VA
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Zip | 24502-7310
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Country | US
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Telephone | 434-237-6337
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Fax | 434-237-6338
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Provider Business Mailing Address
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Address Line | 22776 TIMBERLAKE RD APT D
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City | LYNCHBURG
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State | VA
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Zip | 24502-7310
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Country | US
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Telephone | 434-237-6337
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Fax | 434-237-6338
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Authorized Official
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Title or Position | OWNER
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Name | DR. JODI V. ETTARE
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Credential | PHARMD
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Telephone | 434-237-6337
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 0201004144
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 0201004144
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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