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General NPI Number Information
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NPI Number | 1649204025
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Entity Type | Organization
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Legal Business Name | PENNINGTON DRUG CENTER INC
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 05/20/2019
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Provider Practice Location Address
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Address Line | 41692 W MORGAN AVE
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City | PENNINGTON GAP
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State | VA
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Zip | 24277-3300
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Country | US
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Telephone | 276-546-1551
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Fax | 276-546-6235
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Provider Business Mailing Address
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Address Line | 41692 W MORGAN AVE
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City | PENNINGTON GAP
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State | VA
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Zip | 24277-3300
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Country | US
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Telephone | 276-546-1551
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Fax | 276-546-6235
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Authorized Official
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Title or Position | PRESIDENT
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Name | DENNIS WINSTON PARKER
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Credential |
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Telephone | 276-546-1551
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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 | 0201002084
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License Number State | VA
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