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General NPI Number Information
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NPI Number | 1568487387
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Entity Type | Organization
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Legal Business Name | CAVALIER PHARMACY INC
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 06/10/2014
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Provider Practice Location Address
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Address Line | 301 CHURCH ST
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City | WISE
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State | VA
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Zip | 24293
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Country | US
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Telephone | 276-328-9141
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Fax | 276-328-9130
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Provider Business Mailing Address
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Address Line | PO BOX 1406 301 CHURCH STREET
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City | WISE
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State | VA
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Zip | 24293-1406
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Country | US
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Telephone | 276-328-9141
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Fax | 276-328-9141
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Authorized Official
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Title or Position | PHARMACIST OWNER
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Name | MR. RICK L MULLINS
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Credential | PHARMD
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Telephone | 276-328-9141
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0202012914
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 0201003976
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License Number State | VA
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