Provider Demographics
NPI:1538493382
Name:CHS INC
Entity Type:Organization
Organization Name:CHS INC
Other - Org Name:CARILION CLINIC PHARMACY SALEM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:ADRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-266-6191
Mailing Address - Street 1:3737 W MAIN ST
Mailing Address - Street 2:STE 106
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-2072
Mailing Address - Country:US
Mailing Address - Phone:540-981-7320
Mailing Address - Fax:540-444-7321
Practice Address - Street 1:3737 W MAIN ST
Practice Address - Street 2:STE 106
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-2072
Practice Address - Country:US
Practice Address - Phone:540-981-7320
Practice Address - Fax:540-444-7321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-28
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
VA02010043043336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1538493382Medicaid
2154121OtherPK