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General NPI Number Information
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NPI Number | 1104245596
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Entity Type | Organization
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Legal Business Name | CENTER OF THE UNIVERSE INVESTMENTS LLC
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Dates
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Enumeration Date | 04/14/2014
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Last Update Date | 07/07/2016
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Provider Practice Location Address
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Address Line | 9065 WALDELOCK PL
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City | MECHANICSVILLE
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State | VA
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Zip | 23116-5848
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Country | US
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Telephone | 804-496-6230
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Fax |
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Provider Business Mailing Address
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Address Line | 9065 WALDELOCK PL
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City | MECHANICSVILLE
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State | VA
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Zip | 23116-5848
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Country | US
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Telephone | 804-496-6230
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Fax |
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Authorized Official
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Title or Position | RPH.
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Name | WILLIAM RAYFIELD
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Credential |
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Telephone | 757-695-1964
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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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 0201000045
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License Number State | VA
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