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General NPI Number Information
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NPI Number | 1609326305
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Entity Type | Organization
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Legal Business Name | MAYSONS PHARMACY INC
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Dates
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Enumeration Date | 10/06/2016
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Last Update Date | 02/22/2017
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Provider Practice Location Address
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Address Line | 4199 WINCHESTER RD
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City | MARSHALL
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State | VA
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Zip | 20115-3269
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Country | US
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Telephone | 703-622-0376
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Fax | 540-364-8293
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Provider Business Mailing Address
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Address Line | 4199 WINCHESTER RD
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City | MARSHALL
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State | VA
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Zip | 20115-3269
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Country | US
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Telephone | 703-622-0376
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Fax |
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Authorized Official
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Title or Position | PIC
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Name | SCOTT KIM
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Credential |
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Telephone | 703-622-0376
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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 | 0201004748
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License Number State | VA
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