MEDICARE: JOHNSON FAMILY PHARMACY 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
1	333600000X	Pharmacy	0201002548	VA
2	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4823161	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number	:	1477656510
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHNSON FAMILY PHARMACY INC

Provider Business Mailing Address
First Line	:	PO BOX 300
Second Line	:
City	:	CUMBERLAND
State	:	VA
Zip	:	23040-0300
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1756 ANDERSON HWY
Second Line	:
City	:	CUMBERLAND
State	:	VA
Zip	:	23040
Country	:	US
Telephone Number	:	804-492-4325
Fax Number	:	804-492-9384

Authorized Official
Title or Position	:	PHARMACIST PRESIDENT
Name	:	DWIGHT JOHNSON
Credential	:
Telephone Number	:	804-492-4325

Provider Enumeration Date	:	09/06/2006
Last Update Date	:	09/11/2025

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