Provider Demographics
NPI:1497353692
Name:DAVID JUNE ENTERPRISES LLC
Entity Type:Organization
Organization Name:DAVID JUNE ENTERPRISES LLC
Other - Org Name:HALIFAX LTC PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:434-575-0511
Mailing Address - Street 1:4121 HALIFAX RD STE B
Mailing Address - Street 2:
Mailing Address - City:SOUTH BOSTON
Mailing Address - State:VA
Mailing Address - Zip Code:24592-4833
Mailing Address - Country:US
Mailing Address - Phone:434-575-0511
Mailing Address - Fax:434-575-1366
Practice Address - Street 1:4121 HALIFAX RD STE B
Practice Address - Street 2:
Practice Address - City:SOUTH BOSTON
Practice Address - State:VA
Practice Address - Zip Code:24592-4833
Practice Address - Country:US
Practice Address - Phone:434-575-0511
Practice Address - Fax:434-575-1366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-12
Last Update Date:2020-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy