Provider Demographics
NPI:1285211896
Name:JOHNSTON, ROXIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:ROXIE
Middle Name:
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 452
Mailing Address - Street 2:
Mailing Address - City:PATRICK SPRINGS
Mailing Address - State:VA
Mailing Address - Zip Code:24133-0452
Mailing Address - Country:US
Mailing Address - Phone:276-692-5150
Mailing Address - Fax:
Practice Address - Street 1:976 COMMONWEALTH BLVD
Practice Address - Street 2:
Practice Address - City:MARTINSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24112-1887
Practice Address - Country:US
Practice Address - Phone:276-638-2905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-28
Last Update Date:2021-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202216858183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist