=====================================================
General NPI Number Information
=====================================================
NPI Number | 1154370062
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | J&D PHARMACY INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/08/2006
-----------------------------------------------------
Last Update Date | 03/07/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 372 TOWNE CENTER DR
-----------------------------------------------------
City | ABINGDON
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 24210-3248
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 276-628-3233
-----------------------------------------------------
Fax | 276-623-8325
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 372 TOWNE CENTER DR
-----------------------------------------------------
City | ABINGDON
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 24210-3248
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 276-628-3233
-----------------------------------------------------
Fax | 276-623-8325
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHARMACIST OWNER
-----------------------------------------------------
Name | JAMES ROBERT HARRIS
-----------------------------------------------------
Credential | RPH
-----------------------------------------------------
Telephone | 276-628-3233
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | 0201003289
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------