Provider Demographics
NPI:1154608685
Name:AUGUSTA FAMILY PHARMACY INC.
Entity type:Organization
Organization Name:AUGUSTA FAMILY PHARMACY INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:YEAGER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:540-836-9456
Mailing Address - Street 1:1782 JEFFERSON HWY
Mailing Address - Street 2:UNIT G
Mailing Address - City:FISHERSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22939-2276
Mailing Address - Country:US
Mailing Address - Phone:540-324-8042
Mailing Address - Fax:540-949-4478
Practice Address - Street 1:1782 JEFFERSON HWY
Practice Address - Street 2:UNIT G
Practice Address - City:FISHERSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22939-2276
Practice Address - Country:US
Practice Address - Phone:540-324-8042
Practice Address - Fax:540-949-4478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-11
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA02010044383336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6690440001Medicare NSC