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General NPI Number Information
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NPI Number | 1972582401
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Entity Type | Organization
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Legal Business Name | MANCHESTER HOMES INC
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Dates
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Enumeration Date | 01/12/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1413 MAIN ST
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City | CLIFTON FORGE
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State | VA
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Zip | 24422-1835
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Country | US
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Telephone | 540-862-9046
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Fax | 540-862-0564
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Provider Business Mailing Address
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Address Line | PO BOX 637
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City | CLIFTON FORGE
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State | VA
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Zip | 24422-0637
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Country | US
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Telephone | 540-862-9046
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Fax | 540-862-0564
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | JOAN LOUISE BAY
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Credential | RPH
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Telephone | 540-862-9046
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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 | 0201003708
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License Number State | VA
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