Provider Demographics
NPI:1588655385
Name:FAMILY CARE REMINGTON PHARMACY
Entity type:Organization
Organization Name:FAMILY CARE REMINGTON PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY DIRECTOR VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TRAVIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:HALE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:540-439-7327
Mailing Address - Street 1:208 E MADISON ST
Mailing Address - Street 2:
Mailing Address - City:REMINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22734-9630
Mailing Address - Country:US
Mailing Address - Phone:540-439-7327
Mailing Address - Fax:540-439-7324
Practice Address - Street 1:208 E MADISON ST
Practice Address - Street 2:
Practice Address - City:REMINGTON
Practice Address - State:VA
Practice Address - Zip Code:22734-9630
Practice Address - Country:US
Practice Address - Phone:540-439-7327
Practice Address - Fax:540-439-7324
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-31
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010135672Medicaid
VA6009880001Medicare NSC