CLINCH VALLEY PHARMACY (NPI# 1730242298) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730242298 |
| Entity Type | Organization |
| Organization Name | CLINCH VALLEY PHARMACY |
| Practice Address |
1000 Ben Bolt Avenue Tazewell VA 24651 |
| Mailing Address |
Po Box 548 Tazewell VA 24651-0548 |
| Practice Telephone | 2769884871 |
| Practice Fax Number | 2769886966 |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | JOHN MUNDY (OWNER) |
| Authorized Official Telephone | 2769884871 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 333600000X | Pharmacy | 0201002840 | VA | Suppliers |
| X | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 8502374 | 05 | |
| WV | 0141752000 | 05 | |
| OTHER ID NUMBER-COMMERCIAL NUMBER | 4809983 | 01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | CLINCH VALLEY PHARMACY INCORPORATED | 160 Martingale Drive, Tazewell, Virginia 24651 |
| Street Address |
1000 BEN BOLT AVENUE |
| City | TAZEWELL |
| State | VA |
| Zip Code | 24651 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043663727 | Erich Lutz | Dentist | 215 Central Ave., Tazewell, VA 24651 | 2016-07-19 |
| 1467884114 | Kristie L Stevenson | Speech-Language Pathologist | 982 Benbolt Ave, Tazewll, VA 24651 | 2013-08-05 |
| 1033550355 | Family Preservation Services, Inc | Community/Behavioral Health | 1604 Pisgah Road, Tazewell, VA 24651 | 2013-07-15 |
| 1205056678 | Family Preservation Services, Inc | Community/Behavioral Health | 819 Tazewell Ave, Tazewell, VA 24651 | 2007-04-27 |
| 1083745053 | Southwest Virginia Community Health Systems Inc | Clinic/Center | 386 Ben Bolt Avenue, Tazewell, VA 24651 | 2007-03-08 |
| 1871609792 | Ronald Wayne Householder | Dentist | 316 Ben Bolt Avenue, Tazewell, VA 24651 | 2006-08-22 |
| 1720008485 | Eduardo Torrefranca Tolosa | Family Medicine | 984 Benbolt Avenue, Tazewell, VA 24651 | 2006-07-19 |
| 1619995933 | Rodney Ralston Abrahams I | Dentist | 204 Campbell Ln, Tazewell, VA 24651 | 2006-07-17 |
| 1922048834 | Robert S Rambo | Counselor | 526 W Main St, Tazewell, VA 24651 | 2006-06-08 |
| 1750346979 | Merit Medical Rhc Tazewell Inc | Clinic/Center | 900 Ben Bolt Professional Park, Tazewell, VA 24651 | 2006-04-19 |
| Find all providers in zip 24651 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174620918 | Olde Virginia Pharmacy, Inc. | Pharmacy | 1592 Fincastle Tpke, Tazewell, VA 24651-6167 | 2006-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659998920 | Schiffert Health Center | Pharmacy | 895 Washington Street Sw Virginia Tech Mccomas Hall, Blacksburg, VA 24061-0140 | 2020-07-02 |
| 1912521675 | Duke Pharmacy LLC | Pharmacy | 5130 Duke St Ste 7b, Alexandria, VA 22304-2955 | 2020-05-28 |
| 1942847900 | Medspack Ltc Inc | Pharmacy | 14121 Parke Long Ct Ste 112, Chantilly, VA 20151-1647 | 2019-12-09 |
| 1275175804 | Duyen K Nguyen | Pharmacy | 4497 Morning Wind Ct, Annandale, VA 22003-5902 | 2019-10-15 |
| 1447892450 | Seaside Pharmacy LLC | Pharmacy | 1630 Donna Dr Ste 103, Virginia Beach, VA 23451-6188 | 2019-10-10 |
| 1083255426 | E's-y Rider Cab & Transport Co LLC | Pharmacy | 562 W 29th St, Buena Vista, VA 24416-1506 | 2019-10-07 |
| 1346891918 | Martin's Pharmacy of Rural Retreat Inc | Pharmacy | 100 W Buck Ave, Rural Retreat, VA 24368-2515 | 2019-09-25 |
| 1417418005 | Village Economy Drug Inc | Pharmacy | 443 Duff Patt Hwy Ste 104, Duffield, VA 24244-5191 | 2019-03-27 |
| 1538642434 | Avs Pharmacy LLC | Pharmacy | 161 Fort Evans Rd Ne Ste 115, Leesburg, VA 20176-3370 | 2018-09-07 |
| 1316427347 | Plaza Economy Drug Inc | Pharmacy | 1123 Plaza Dr, Grundy, VA 24614-6780 | 2018-08-20 |
| 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.