Provider Demographics
NPI:1154370062
Name:J&D PHARMACY INC
Entity type:Organization
Organization Name:J&D PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:276-628-3233
Mailing Address - Street 1:372 TOWNE CENTER DR
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24210-3248
Mailing Address - Country:US
Mailing Address - Phone:276-628-3233
Mailing Address - Fax:276-623-8325
Practice Address - Street 1:372 TOWNE CENTER DR
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24210-3248
Practice Address - Country:US
Practice Address - Phone:276-628-3233
Practice Address - Fax:276-623-8325
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-08
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA02010032893336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA008507295Medicaid
VA9109595Medicaid
VA4829389OtherUNIVERSAL NABP NUMBER
VA0201003289OtherPHARMACY LISCENSE NUMBER
VA0201003289OtherPHARMACY LISCENSE NUMBER
VA5921740001Medicare NSC