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General NPI Number Information
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NPI Number | 1346891918
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Entity Type | Organization
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Legal Business Name | MARTIN'S PHARMACY OF RURAL RETREAT INC
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Dates
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Enumeration Date | 09/25/2019
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Last Update Date | 06/24/2020
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Provider Practice Location Address
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Address Line | 100 W BUCK AVE
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City | RURAL RETREAT
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State | VA
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Zip | 24368-2515
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Country | US
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Telephone | 276-250-2160
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Fax | 276-250-2184
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Provider Business Mailing Address
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Address Line | PO BOX 699
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City | PULASKI
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State | VA
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Zip | 24301-0699
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Country | US
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Telephone | 540-230-4250
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Fax | 540-980-3784
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Authorized Official
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Title or Position | DIRECTOR OF CORPORATION
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Name | DR. WILLIAM HAMPTON HALE
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Credential | PHARM.D.
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Telephone | 540-230-4250
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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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