Provider Demographics
NPI:1396763751
Name:PHARMACY PLUS INC.
Entity type:Organization
Organization Name:PHARMACY PLUS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:H
Authorized Official - Last Name:BAHLMAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:RPH
Authorized Official - Phone:804-520-2400
Mailing Address - Street 1:658 WHITE HORSE DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-7829
Mailing Address - Country:US
Mailing Address - Phone:252-752-2363
Mailing Address - Fax:252-752-0358
Practice Address - Street 1:2029 BOULEVARD
Practice Address - Street 2:
Practice Address - City:COLONIAL HEIGHTS
Practice Address - State:VA
Practice Address - Zip Code:23834-2309
Practice Address - Country:US
Practice Address - Phone:804-520-2400
Practice Address - Fax:804-526-7847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA02010025813336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA9137491Medicaid
VA4823200OtherNABP
VA8503851Medicaid
VA9137491Medicaid