Provider Demographics
NPI:1275101545
Name:SHAWSVILLE PHARMACY INC
Entity Type:Organization
Organization Name:SHAWSVILLE PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JACOB
Authorized Official - Last Name:QUINONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-577-8441
Mailing Address - Street 1:250 ALLEGHANY SPRING RD
Mailing Address - Street 2:
Mailing Address - City:SHAWSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24162
Mailing Address - Country:US
Mailing Address - Phone:540-268-2600
Mailing Address - Fax:540-268-2605
Practice Address - Street 1:250 ALLEGHANY SPRING RD
Practice Address - Street 2:
Practice Address - City:SHAWSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24162-2416
Practice Address - Country:US
Practice Address - Phone:540-268-2600
Practice Address - Fax:540-268-2605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-14
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy