=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477656510
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JOHNSON FAMILY PHARMACY INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/06/2006
-----------------------------------------------------
Last Update Date | 09/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1756 ANDERSON HWY
-----------------------------------------------------
City | CUMBERLAND
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23040
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 804-492-4325
-----------------------------------------------------
Fax | 804-492-9384
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 300
-----------------------------------------------------
City | CUMBERLAND
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23040-0300
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHARMACIST PRESIDENT
-----------------------------------------------------
Name | DWIGHT JOHNSON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 804-492-4325
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 333600000X
-----------------------------------------------------
Taxonomy Name | Pharmacy
-----------------------------------------------------
License Number | 0201002548
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------