Provider Demographics
NPI:1255474201
Name:KRISTA INC
Entity Type:Organization
Organization Name:KRISTA INC
Other - Org Name:MIDDLEBURG PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KRISTA
Authorized Official - Middle Name:C
Authorized Official - Last Name:GARBER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:540-687-3411
Mailing Address - Street 1:11 S. MADISON ST.
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20117
Mailing Address - Country:US
Mailing Address - Phone:540-687-3411
Mailing Address - Fax:540-687-3411
Practice Address - Street 1:11 S. MADISON ST
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG
Practice Address - State:VA
Practice Address - Zip Code:20117
Practice Address - Country:US
Practice Address - Phone:540-687-3411
Practice Address - Fax:540-687-3411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA02010025743336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy