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General NPI Number Information
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NPI Number | 1508006461
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Entity Type | Organization
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Legal Business Name | CAVALIER PHARMACY 2 INC
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Dates
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Enumeration Date | 03/04/2009
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Last Update Date | 05/29/2009
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Provider Practice Location Address
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Address Line | 336 COEBURN AVE SW
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City | NORTON
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State | VA
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Zip | 24273
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Country | US
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Telephone | 276-679-0888
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Fax | 276-679-0404
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Provider Business Mailing Address
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Address Line | PO BOX 1245
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City | NORTON
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State | VA
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Zip | 24273-0917
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | RICK MULLINS
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Credential |
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Telephone | 276-679-0888
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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 | 0201004285
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License Number State | VA
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