Provider Demographics
NPI:1619086725
Name:YORK DRUG INC.
Entity Type:Organization
Organization Name:YORK DRUG INC.
Other - Org Name:POQUOSON PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN CHARGE AND OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:RICE
Authorized Official - Last Name:CREECY
Authorized Official - Suffix:V
Authorized Official - Credentials:RPH
Authorized Official - Phone:757-868-7114
Mailing Address - Street 1:498 WYTHE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:POQUOSON
Mailing Address - State:VA
Mailing Address - Zip Code:23662-1936
Mailing Address - Country:US
Mailing Address - Phone:757-868-7114
Mailing Address - Fax:757-868-7922
Practice Address - Street 1:498 WYTHE CREEK RD
Practice Address - Street 2:
Practice Address - City:POQUOSON
Practice Address - State:VA
Practice Address - Zip Code:23662-1936
Practice Address - Country:US
Practice Address - Phone:757-868-7114
Practice Address - Fax:757-868-7922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0014658815332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA009103325Medicaid
VA008500843Medicaid
VA870001880Medicare PIN
VA009103325Medicaid