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General NPI Number Information
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NPI Number | 1275637241
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Entity Type | Organization
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Legal Business Name | NORTON COMMUNITY PHYSICIAN SERVICES LLC
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Dates
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Enumeration Date | 09/12/2006
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Last Update Date | 01/24/2024
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Provider Practice Location Address
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Address Line | 1490 PARK AVE NW STE 7
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City | NORTON
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State | VA
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Zip | 24273-1631
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Country | US
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Telephone | 276-439-1360
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Fax | 276-439-1305
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Provider Business Mailing Address
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Address Line | 311 PRINCETON RD STE 1
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City | JOHNSON CITY
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State | TN
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Zip | 37601-2080
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Country | US
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Telephone | 276-439-1360
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Fax | 276-439-1305
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Authorized Official
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Title or Position | SVP
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Name | CARL STEVEN KILGORE
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Credential |
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Telephone | 423-915-5185
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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 | 0201002745
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License Number State | VA
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