Provider Demographics
NPI:1720341290
Name:APPOMATTOX DRUGS
Entity Type:Organization
Organization Name:APPOMATTOX DRUGS
Other - Org Name:APPOMATTOX DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER PHARMACIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:EPPS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:804-469-9139
Mailing Address - Street 1:21414 CHESTERFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23803-2408
Mailing Address - Country:US
Mailing Address - Phone:804-520-4282
Mailing Address - Fax:804-520-4285
Practice Address - Street 1:21414 CHESTERFIELD AVE
Practice Address - Street 2:
Practice Address - City:SOUTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23803-2408
Practice Address - Country:US
Practice Address - Phone:804-520-4282
Practice Address - Fax:804-520-4285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-20
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202005189183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty