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General NPI Number Information
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NPI Number | 1093352353
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Entity Type | Organization
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Legal Business Name | TEMPLE AVE PHARMACY
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Dates
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Enumeration Date | 12/05/2019
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Last Update Date | 12/05/2019
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Provider Practice Location Address
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Address Line | 2000 SNEAD AVE
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City | COLONIAL HEIGHTS
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State | VA
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Zip | 23834-2428
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Country | US
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Telephone | 804-526-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 2000 SNEAD AVE
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City | COLONIAL HEIGHTS
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State | VA
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Zip | 23834-2428
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | SCOTT KIM
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Credential |
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Telephone | 804-526-1000
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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 |
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License Number State |
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