Provider Demographics
NPI:1487716569
Name:YORK DRUG INC
Entity type:Organization
Organization Name:YORK DRUG INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:CREECY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:757-868-7114
Mailing Address - Street 1:498 WYTHE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:POQUOSON
Mailing Address - State:VA
Mailing Address - Zip Code:23662-1936
Mailing Address - Country:US
Mailing Address - Phone:757-868-7114
Mailing Address - Fax:757-868-7922
Practice Address - Street 1:498 WYTHE CREEK RD
Practice Address - Street 2:
Practice Address - City:POQUOSON
Practice Address - State:VA
Practice Address - Zip Code:23662-1936
Practice Address - Country:US
Practice Address - Phone:757-868-7114
Practice Address - Fax:757-868-7922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2011-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0004X, 332B00000X, 333600000X
VA02010028813336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA008500843Medicaid
VA009103325Medicaid
4825785OtherNCPDP PROVIDER IDENTIFICATION NUMBER
4825785OtherNCPDP PROVIDER IDENTIFICATION NUMBER