Provider Demographics
NPI:1578252557
Name:KILMARNOCK PHARMACY INC
Entity Type:Organization
Organization Name:KILMARNOCK PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CAROLL
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:THROCKMORTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-435-8818
Mailing Address - Street 1:PO BOX 1299
Mailing Address - Street 2:
Mailing Address - City:KILMARNOCK
Mailing Address - State:VA
Mailing Address - Zip Code:22482-1299
Mailing Address - Country:US
Mailing Address - Phone:804-435-8818
Mailing Address - Fax:804-435-8898
Practice Address - Street 1:308 N MAIN ST
Practice Address - Street 2:
Practice Address - City:KILMARNOCK
Practice Address - State:VA
Practice Address - Zip Code:22482-3834
Practice Address - Country:US
Practice Address - Phone:804-435-8818
Practice Address - Fax:804-435-8898
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KILMARNOCK PHARMACY INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-05-04
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy