Provider Demographics
NPI:1700131927
Name:R & S PHARMACY
Entity Type:Organization
Organization Name:R & S PHARMACY
Other - Org Name:HAMPTON HEALTH MART PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER, PIC
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:MCPHEE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:757-718-2812
Mailing Address - Street 1:3321 W MERCURY BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-3806
Mailing Address - Country:US
Mailing Address - Phone:757-864-0380
Mailing Address - Fax:757-864-0486
Practice Address - Street 1:3321 W MERCURY BLVD STE D
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-3806
Practice Address - Country:US
Practice Address - Phone:757-864-0380
Practice Address - Fax:757-864-0486
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-14
Last Update Date:2014-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA02010044983336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1700131927Medicaid
2136105OtherPK