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General NPI Number Information
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NPI Number | 1801454541
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Entity Type | Organization
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Legal Business Name | HENRICO RX LLC
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Dates
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Enumeration Date | 05/29/2019
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Last Update Date | 07/02/2019
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Provider Practice Location Address
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Address Line | 8705 W BROAD ST
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City | HENRICO
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State | VA
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Zip | 23294-6207
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Country | US
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Telephone | 804-239-1990
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Fax | 888-506-6133
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Provider Business Mailing Address
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Address Line | 8705 W BROAD ST
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City | HENRICO
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State | VA
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Zip | 23294-6207
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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 | OWNER
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Name | DYLAN LAUBSCHER
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Credential |
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Telephone | 804-239-1990
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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 |
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License Number State |
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