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General NPI Number Information
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NPI Number | 1932634953
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Entity Type | Organization
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Legal Business Name | BIG STONE ECONOMY DRUG INC
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Dates
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Enumeration Date | 04/27/2017
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Last Update Date | 03/18/2024
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Provider Practice Location Address
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Address Line | 419 SHAWNEE AVE E
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City | BIG STONE GAP
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State | VA
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Zip | 24219-2817
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Country | US
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Telephone | 276-524-4204
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Fax | 276-524-4206
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Provider Business Mailing Address
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Address Line | PO BOX 205
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City | HURLEY
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State | VA
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Zip | 24620-0205
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Country | US
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Telephone | 276-524-4204
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Fax | 276-524-4206
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Authorized Official
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Title or Position | OWNER/PHARMACIST
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Name | DAVID BROWN
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Credential |
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Telephone | 276-971-3811
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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 | 0201004771
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License Number State | VA
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