Provider Demographics
NPI:1497858690
Name:AMERICAN DRUG CENTER, INC.
Entity Type:Organization
Organization Name:AMERICAN DRUG CENTER, INC.
Other - Org Name:MED EMPORIUM #14
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RANJEEV
Authorized Official - Middle Name:
Authorized Official - Last Name:GULIANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-971-2426
Mailing Address - Street 1:2322 E LITTLE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23518-3225
Mailing Address - Country:US
Mailing Address - Phone:757-480-6402
Mailing Address - Fax:757-480-8395
Practice Address - Street 1:701 BATTLEFIELD BLVD N
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-4943
Practice Address - Country:US
Practice Address - Phone:757-312-0133
Practice Address - Fax:757-312-0275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010053331Medicaid
VA010053331Medicaid