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General NPI Number Information
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NPI Number | 1154146389
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Entity Type | Organization
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Legal Business Name | COMMONSHARE IMPERIAL LLC
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Dates
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Enumeration Date | 11/21/2024
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Last Update Date | 11/21/2024
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Provider Practice Location Address
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Address Line | 1717 BELLEVUE AVE # 11
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City | RICHMOND
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State | VA
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Zip | 23227-3961
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Country | US
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Telephone | 804-688-1777
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Fax | 804-410-1035
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Provider Business Mailing Address
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Address Line | 1602 SKIPWITH RD STE 201
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City | HENRICO
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State | VA
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Zip | 23229-5205
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Country | US
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Telephone | 804-416-6255
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Fax | 804-967-3999
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MR. WILLIAM MILTON WEIMER II
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Credential |
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Telephone | 804-424-0551
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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 |
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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 |
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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 |
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License Number State |
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