Provider Demographics
NPI:1306312608
Name:SOUTHERN VIRGINIA CONSULTANT PHARMACY LLC
Entity type:Organization
Organization Name:SOUTHERN VIRGINIA CONSULTANT PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:RUTH
Authorized Official - Last Name:STEVENS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:434-835-2509
Mailing Address - Street 1:PO BOX 10956
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24543-5016
Mailing Address - Country:US
Mailing Address - Phone:434-835-2509
Mailing Address - Fax:434-835-2586
Practice Address - Street 1:625 PINEY FOREST RD STE 301B
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24540-2869
Practice Address - Country:US
Practice Address - Phone:434-835-2509
Practice Address - Fax:434-835-2586
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-15
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy