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NPI Code Detail

MEDICARE: THE WOODLAND INC

MEDICARE: THE WOODLAND INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13336C0003XCommunity/Retail Pharmacy
23336L0003XLong Term Care Pharmacy0201004200VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14840662OTHERNCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number : 1265617880
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE WOODLAND INC
Provider Business Mailing Address
First Line : 2003 COBB ST
Second Line :
City : FARMVILLE
State : VA
Zip : 23901-2603
Country : US
Telephone Number : 434-392-6106
Fax Number : 434-315-0120
Provider Business Practice Location Address
First Line : 2003 COBB ST
Second Line :
City : FARMVILLE
State : VA
Zip : 23901-2603
Country : US
Telephone Number : 434-392-6106
Fax Number : 434-315-0120
Authorized Official
Title or Position : DIRECTOR OF PHCY
Name : ROBERT JEFFERSON
Credential : RPH
Telephone Number : 434-392-6106
Provider Enumeration Date : 01/02/2008
Last Update Date : 01/15/2010

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Directions to “THE WOODLAND INC ” Practice Location

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