Provider Demographics
NPI:1124052550
Name:IRWIN'S PHARMACY AND DRUG CO. INC.
Entity type:Organization
Organization Name:IRWIN'S PHARMACY AND DRUG CO. INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:757-420-8418
Mailing Address - Street 1:4300 INDIAN RIVER RD
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23325-3116
Mailing Address - Country:US
Mailing Address - Phone:757-420-8418
Mailing Address - Fax:757-424-9615
Practice Address - Street 1:4300 INDIAN RIVER RD
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23325-3116
Practice Address - Country:US
Practice Address - Phone:757-420-8418
Practice Address - Fax:757-424-9615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0003X, 3336L0003X, 3336C0002X
VA0201000375332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0157670001Medicare NSC
VA=========Medicare ID - Type Unspecified