Provider Demographics
NPI:1366204109
Name:DOWNHOME PHARMACY-VINTON
Entity type:Organization
Organization Name:DOWNHOME PHARMACY-VINTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:
Authorized Official - Last Name:LUCAS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:540-566-4005
Mailing Address - Street 1:1098 BYPASS ROAD
Mailing Address - Street 2:
Mailing Address - City:VINTON
Mailing Address - State:VA
Mailing Address - Zip Code:24179
Mailing Address - Country:US
Mailing Address - Phone:540-566-4005
Mailing Address - Fax:540-566-3161
Practice Address - Street 1:1098 BYPASS ROAD
Practice Address - Street 2:
Practice Address - City:VINTON
Practice Address - State:VA
Practice Address - Zip Code:24179
Practice Address - Country:US
Practice Address - Phone:540-566-4005
Practice Address - Fax:540-566-3161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-26
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy