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General NPI Number Information
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NPI Number | 1952962581
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Entity Type | Organization
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Legal Business Name | AG PHARMACY, LLC
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Dates
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Enumeration Date | 06/25/2019
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Last Update Date | 09/28/2020
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Provider Practice Location Address
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Address Line | 3322 HOLLAND RD STE A
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452-4826
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Country | US
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Telephone | 757-689-3972
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Fax | 757-686-4339
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Provider Business Mailing Address
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Address Line | 3322 HOLLAND RD STE A
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452-4826
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Country | US
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Telephone | 757-689-3972
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Fax | 757-689-4339
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Authorized Official
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Title or Position | OWNER
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Name | ADRIENNE GAUTIER
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Credential |
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Telephone | 757-689-3972
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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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