Provider Demographics
NPI:1154146389
Name:COMMONSHARE IMPERIAL LLC
Entity type:Organization
Organization Name:COMMONSHARE IMPERIAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:MILTON
Authorized Official - Last Name:WEIMER
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:804-424-0551
Mailing Address - Street 1:1602 SKIPWITH RD STE 201
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23229-5205
Mailing Address - Country:US
Mailing Address - Phone:804-416-6255
Mailing Address - Fax:804-967-3999
Practice Address - Street 1:1717 BELLEVUE AVE # 11
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23227-3961
Practice Address - Country:US
Practice Address - Phone:804-688-1777
Practice Address - Fax:804-410-1035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy