BURNT CHIMNEY PHARMACY (NPI# 1710981618) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710981618 |
| Entity Type | Organization |
| Organization Name | BURNT CHIMNEY PHARMACY |
| Other Organization Name | SUPER D DRUG STORE |
| Practice Address |
2152 Dale Ave Se Roanoke VA 24013-2136 |
| Practice Telephone | 5403458342 |
| Practice Fax Number | 5403458237 |
| Mailing Telephone | 5403458342 |
| Mailing Fax Number | 5403458237 |
| Enumeration Date | 2005-06-08 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | EMILY HETHERINGTON (CERTIFIED PHARMACY TECHNICIAN) |
| Authorized Official Telephone | 5403458342 |
| Authorized Official Credential | CPHT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183700000X | Pharmacy Technician | 0230003079 | VA | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | NABP | 4828705 | 01 |
| 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 |
2152 DALE AVE SE |
| City | ROANOKE |
| State | VA |
| Zip Code | 24013-2136 |
| 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 | 183700000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacy Technician |
| A person who works under the direct supervision of a licensed pharmacist and performs many pharmacy-related functions that do not require the professional judgment of a pharmacist. |
| Notes: Source: Pharmacy Technician Certification Board, www.ptcb.org [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851911283 | Christopher Tiller | Pharmacy Technician | 3501 Chesterbrook Ct Apt 633, Henrico, VA 23233-1297 | 2020-04-27 |
| 1255951513 | Delea Dawn Edwards | Pharmacy Technician | 165 Boxwood Ln, Galax, VA 24333-6435 | 2020-04-16 |
| 1902434871 | Oscar W Miranda | Pharmacy Technician | 6501 Loisdale Ct Ste 1100, Springfield, VA 22150-1885 | 2020-03-27 |
| 1700412038 | Victor Gituma Njogu | Pharmacy Technician | 1527 28th St S Apt 4, Arlington, VA 22206-3235 | 2020-03-18 |
| 1548735624 | Adrian David Canfield | Pharmacy Technician | 7100 Able Rd, Chesterfield, VA 23832-8417 | 2018-10-04 |
| 1649755745 | Mirian Silva Naybor | Pharmacy Technician | 5614 Flag Run Dr, Springfield, VA 22151-2725 | 2018-09-25 |
| 1619359882 | Daniel Ngembus | Pharmacy Technician | 10331 Staples Mill Rd, Glen Allen, VA 23060-3252 | 2015-06-24 |
| 1629463476 | Jennifer Keyton | Pharmacy Technician | 2003 Chestnut Dr, Culpeper, VA 22701-4105 | 2015-03-30 |
| 1083005896 | Hillary Wiles-lafayette | Pharmacy Technician | Vcuhs Department of Medicine-emergency Med 980401, 1250 E Marshall Street, Richmond, VA 23298-0401 | 2015-02-16 |
| 1134510035 | Kimberly Hoy | Pharmacy Technician | 1602 Waters Edge Ln, Suffolk, VA 23435-2853 | 2015-02-12 |
| Find all providers with the same taxonomy | ||||
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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.