BURNT CHIMNEY PHARMACY INC. (NPI# 1639191638) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639191638 |
| Entity Type | Organization |
| Organization Name | BURNT CHIMNEY PHARMACY INC. |
| Other Organization Name | SUPER-D DRUG STORE |
| Practice Address |
414 9th St Se Roanoke VA 24013-1506 |
| Practice Telephone | 5403458342 |
| Practice Fax Number | 5403458237 |
| Mailing Telephone | 5403458342 |
| Mailing Fax Number | 5403458237 |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. GERALD BRUCE THOMPSON (GENERAL MANAGER) |
| Authorized Official Telephone | 5403458342 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 0201003224 | VA | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 8514020 | 05 |
| Other Name | Type Code |
|---|---|
| Super-D Drug Store | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | BURNT CHIMNEY PHARMACY INC. | 414 9th St Se, Roanoke, Virginia 24013-1506 |
| Street Address |
414 9TH ST SE |
| City | ROANOKE |
| State | VA |
| Zip Code | 24013-1506 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932379120 | Judith Kay Thompson | Pharmacist | 414 9th St Se, Roanoke, VA 24013-1506 | 2008-03-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114091485 | Amy Barker | Registered Nurse | 102 Highland Ave Se Ste 203, Roanoke, VA 24013 | 2006-11-20 |
| 1992888432 | Valley Home Health Care LLC | Durable Medical Equipment & Medical Supplies | 1212 Campbell Ave Se, Roanoke, VA 24013 | 2006-10-20 |
| 1245325786 | Travis Pg Barham | Dentist | 101 Elm Ave, Roanoke, VA 24013 | 2006-10-03 |
| 1801251806 | Emily Lawson Bennett | Nurse Practitioner | 101 Elm Ave Se, Roanoke, VA 24013 | 2015-12-18 |
| 1629455936 | Mebratu Daba | Pediatrics | 102 Highland Ave Se Ste 104, Roanoke, VA 24013 | 2015-05-06 |
| 1720475296 | Hussein Elmufti | Pediatrics | 102 Highland Ave Se Ste 455, Roanoke, VA 24013 | 2015-04-22 |
| 1861467847 | Kilian H. Brech II | Pediatrics | 21 Highland Ave Se Ste 100, Roanoke, VA 24013 | 2006-02-22 |
| 1114545928 | Raven Matthews | Emergency Medicine | 213 18th St Se, Roanoke, VA 24013-1311 | 2020-07-08 |
| 1356557102 | Sandra Elaine Sayre | Nurse Practitioner | 402 4th St Se, Roanoke, VA 24013-1404 | 2007-05-15 |
| 1982041000 | Family Preservation Services, Inc. | Community/Behavioral Health | 825 Stewart Ave Se, Roanoke, VA 24013-1443 | 2013-05-30 |
| Find all providers in zip 24013 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417558602 | Irene Pace Seidman | Pharmacist | 3350 Clearbrook Village Ln, Roanoke, VA 24014 | 2020-11-04 |
| 1609402239 | Xuan Huyen Nguyen | Pharmacist | 4412 Elmgreen Dr, Roanoke, TX 76262-2709 | 2020-03-16 |
| 1225506108 | Jessica Saville | Pharmacist | 101 Elm Ave Se Fl 1, Roanoke, VA 24013-2222 | 2018-11-08 |
| 1972071439 | Jessica Lynn Schad | Pharmacist | 1906 Belleview Ave Se Fl 14, Roanoke, VA 24014-1838 | 2018-11-02 |
| 1851833545 | Rual Fuller Jr. | Pharmacist | 3419 Orange Ave Ne, Roanoke, VA 24012-6422 | 2016-11-10 |
| 1538576053 | Sarah Webb | Pharmacist | 2141 Dale Ave Se, Roanoke, VA 24013-2135 | 2014-07-16 |
| 1881011203 | Neeraja Iyer | Pharmacist | 1932 Summerfield Dr, Roanoke, VA 24012-6768 | 2014-03-24 |
| 1023434958 | Michael Elgohary | Pharmacist | 3114 Honeywood Ln Apt A, Roanoke, VA 24018 | 2014-03-17 |
| 1255755419 | Sam Fontinel | Pharmacist | 5512 Capulet Ct, Roanoke, VA 24018-9368 | 2014-02-08 |
| 1578987871 | Chad Evan Musick | Pharmacist | 3533 Freanklin Rd Sw, Roanoke, VA 26013 | 2014-02-07 |
| Find all providers in ROANOKE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.