Provider Demographics
NPI:1356307144
Name:WINDSOR PHARMACY, INC.
Entity Type:Organization
Organization Name:WINDSOR PHARMACY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:R
Authorized Official - Last Name:PARSONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-242-6191
Mailing Address - Street 1:PO BOX 288
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:VA
Mailing Address - Zip Code:23487-0288
Mailing Address - Country:US
Mailing Address - Phone:757-242-6191
Mailing Address - Fax:757-242-3602
Practice Address - Street 1:12 E WINDSOR BLVD
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:VA
Practice Address - Zip Code:23487-9442
Practice Address - Country:US
Practice Address - Phone:757-242-6191
Practice Address - Fax:757-242-3602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA02010011923336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0201001192OtherPHARMACY LICENSE NUMBER
VA8509450Medicaid
VA4810429OtherNABP NUMBER
VA4810429OtherNABP NUMBER