Provider Demographics
NPI:1306164835
Name:CHATHAM FAMILY PHARMACY
Entity type:Organization
Organization Name:CHATHAM FAMILY PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:HARPER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:276-627-0536
Mailing Address - Street 1:13701 US HIGHWAY 29
Mailing Address - Street 2:SUITE H1
Mailing Address - City:CHATHAM
Mailing Address - State:VA
Mailing Address - Zip Code:24531-3611
Mailing Address - Country:US
Mailing Address - Phone:434-432-0780
Mailing Address - Fax:434-432-0785
Practice Address - Street 1:13701 US HIGHWAY 29
Practice Address - Street 2:SUITE H1
Practice Address - City:CHATHAM
Practice Address - State:VA
Practice Address - Zip Code:24531-3611
Practice Address - Country:US
Practice Address - Phone:434-432-0780
Practice Address - Fax:434-432-0785
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FAMILY DISCOUNT PHARMACY, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-05-07
Last Update Date:2010-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA02010043383336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy