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General NPI Number Information
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NPI Number | 1508134628
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Entity Type | Organization
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Legal Business Name | PIEDMONT PHARMACY INC
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Dates
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Enumeration Date | 12/03/2011
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Last Update Date | 09/07/2012
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Provider Practice Location Address
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Address Line | 305 MOUNT CROSS RD
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City | DANVILLE
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State | VA
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Zip | 24540-4045
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Country | US
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Telephone | 434-791-3784
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Fax | 434-791-2554
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Provider Business Mailing Address
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Address Line | 305 MOUNT CROSS RD
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City | DANVILLE
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State | VA
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Zip | 24540-4045
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Country | US
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Telephone | 434-791-3784
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Fax | 434-791-2554
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. VANCE KISER
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Credential |
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Telephone | 434-251-4839
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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 | 0201004439
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License Number State | VA
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