Provider Demographics
NPI:1295729192
Name:DRUG CENTER PHARMACY INC
Entity type:Organization
Organization Name:DRUG CENTER PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:CARTER
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:757-393-4039
Mailing Address - Street 1:600 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23704-3424
Mailing Address - Country:US
Mailing Address - Phone:757-393-4039
Mailing Address - Fax:757-397-8491
Practice Address - Street 1:600 HIGH ST
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23704-3424
Practice Address - Country:US
Practice Address - Phone:757-393-4039
Practice Address - Fax:757-397-8491
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-07
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202009801333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA008509441Medicaid
VA1218100001Medicare ID - Type Unspecified