Provider Demographics
NPI:1639152036
Name:CEDARFIELD CORPORATION
Entity Type:Organization
Organization Name:CEDARFIELD CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:OLEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:804-968-5530
Mailing Address - Street 1:7016 LEE PARK RD STE 300
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23111-3627
Mailing Address - Country:US
Mailing Address - Phone:804-968-5530
Mailing Address - Fax:804-217-8281
Practice Address - Street 1:7016 LEE PARK RD STE 300
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23111-3627
Practice Address - Country:US
Practice Address - Phone:804-968-5530
Practice Address - Fax:804-217-8281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-21
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA02010003348333600000X, 3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1255030001Medicare NSC