Provider Demographics
NPI:1134961055
Name:LOVETTSVILLE PHARMACY CORPORATION
Entity type:Organization
Organization Name:LOVETTSVILLE PHARMACY CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DHARMALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-229-5144
Mailing Address - Street 1:11 TOWN CENTER DR STE 195
Mailing Address - Street 2:
Mailing Address - City:LOVETTSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20180-8569
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11 TOWN CENTER DR STE 195
Practice Address - Street 2:
Practice Address - City:LOVETTSVILLE
Practice Address - State:VA
Practice Address - Zip Code:20180-8569
Practice Address - Country:US
Practice Address - Phone:540-306-5839
Practice Address - Fax:540-991-5213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-11
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy