Provider Demographics
NPI:1235288069
Name:PAYNE REMEDIES INC
Entity Type:Organization
Organization Name:PAYNE REMEDIES INC
Other - Org Name:MEDICAP PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JATHAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:PAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:540-433-6337
Mailing Address - Street 1:2091 PRO POINTE LN
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-8021
Mailing Address - Country:US
Mailing Address - Phone:540-433-6337
Mailing Address - Fax:540-433-7091
Practice Address - Street 1:2091 PRO POINTE LN
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-8021
Practice Address - Country:US
Practice Address - Phone:540-433-6337
Practice Address - Fax:540-433-7091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0201004035332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies