Provider Demographics
NPI:1124118641
Name:WEST POINT ACQUISITION CORP
Entity type:Organization
Organization Name:WEST POINT ACQUISITION CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRES PIC
Authorized Official - Prefix:
Authorized Official - First Name:MYRON
Authorized Official - Middle Name:
Authorized Official - Last Name:HODGES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-694-5815
Mailing Address - Street 1:PO BOX 9
Mailing Address - Street 2:
Mailing Address - City:GLOUCESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23061-0009
Mailing Address - Country:US
Mailing Address - Phone:804-694-5815
Mailing Address - Fax:
Practice Address - Street 1:7453 HARGETT BLVD
Practice Address - Street 2:
Practice Address - City:GLOUCESTER
Practice Address - State:VA
Practice Address - Zip Code:23061-2038
Practice Address - Country:US
Practice Address - Phone:804-694-5815
Practice Address - Fax:804-695-0216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
VA02010035313336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2102936OtherPK
VA8505161Medicaid
VA8505161Medicaid