Provider Demographics
NPI:1780977538
Name:RICHMOND AREA COMPASSIONATE CARE PHARMACY
Entity type:Organization
Organization Name:RICHMOND AREA COMPASSIONATE CARE PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY AND PHARMACIST-IN-CHARGE
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:ALFRED
Authorized Official - Last Name:GREGORY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:804-672-1226
Mailing Address - Street 1:1300 MACTAVISH AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-4633
Mailing Address - Country:US
Mailing Address - Phone:804-977-5981
Mailing Address - Fax:
Practice Address - Street 1:1300 MACTAVISH AVE
Practice Address - Street 2:SUITE A
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-4633
Practice Address - Country:US
Practice Address - Phone:804-977-5981
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-25
Last Update Date:2011-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA02010043903336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy