Provider Demographics
NPI:1215960323
Name:HAMILTON PHARMACY INC
Entity type:Organization
Organization Name:HAMILTON PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT , CO OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:LAWRENCE
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:276-762-9080
Mailing Address - Street 1:16610 RUSSELL STREET
Mailing Address - Street 2:P.O. BOX 977
Mailing Address - City:ST PAUL
Mailing Address - State:VA
Mailing Address - Zip Code:24283
Mailing Address - Country:US
Mailing Address - Phone:276-762-9080
Mailing Address - Fax:276-762-9081
Practice Address - Street 1:16610 RUSSELL STREET
Practice Address - Street 2:
Practice Address - City:ST PAUL
Practice Address - State:VA
Practice Address - Zip Code:24283
Practice Address - Country:US
Practice Address - Phone:276-762-9080
Practice Address - Fax:276-762-9081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0201004004332B00000X, 333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
VABH9065473OtherDEA NUMBER
VABH9065473OtherDEA NUMBER