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General NPI Number Information
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NPI Number | 1184721011
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Entity Type | Organization
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Legal Business Name | WOODYS PHARMACY INC
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 04/14/2017
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Provider Practice Location Address
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Address Line | 576 E MAIN ST
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City | INDEPENDENCE
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State | VA
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Zip | 24348-3879
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Country | US
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Telephone | 276-773-2211
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Fax | 276-773-2223
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Provider Business Mailing Address
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Address Line | PO BOX 190
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City | INDEPENDENCE
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State | VA
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Zip | 24348-0190
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Country | US
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Telephone | 276-773-2211
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/PIC
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Name | WOODROW PACK
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Credential |
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Telephone | 276-773-2211
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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 | 0201001867
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License Number State | VA
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