MEDICARE: PARKWAY 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
2	3336C0003X	Community/Retail Pharmacy	0201003564	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	2104203	OTHER	PK

General Provider Information

NPI Number	:	1952346322
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PARKWAY PHARMACY INC

Provider Business Mailing Address
First Line	:	PO BOX 8
Second Line	:
City	:	CROZET
State	:	VA
Zip	:	22932-0008
Country	:	US
Telephone Number	:	434-823-6337
Fax Number	:	434-823-1912

Provider Business Practice Location Address
First Line	:	5771 THE SQ
Second Line	:
City	:	CROZET
State	:	VA
Zip	:	22932-3182
Country	:	US
Telephone Number	:	434-823-6337
Fax Number	:	434-823-1912

Authorized Official
Title or Position	:	OWNER
Name	:	PAUL PLANTZ
Credential	:
Telephone Number	:	434-823-6337

Provider Enumeration Date	:	06/18/2006
Last Update Date	:	08/10/2016

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Directions to “PARKWAY PHARMACY INC ” Practice Location

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