NPIMap

Organization Active NPI

Boydton Community Pharmacy

  • Pharmacy
  • Boydton, VA
National Provider Identifier
1104880582
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
BOYDTON COMMUNITY PHARMACY
Practice address
390 Washington St
Boydton, VA 23917
Phone
(434) 738-6102
Fax
(434) 738-6982
NPI assigned
Apr 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Carol Dill
Title
Executive Director
Phone
(434) 738-6102

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X Primary

Addresses

Primary practice location

390 Washington St
Boydton, VA 23917

Mailing address

390 Washington St
Boydton, VA 23917
Phone (434) 738-6102

Other identifiers 1

IdentifierTypeStateIssuer
8506035MedicaidVA

National Provider Directory

National Provider Directory
Tax ID family
Boydton Community Health Facility Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104880582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 WASHINGTON ST",
            "city": "BOYDTON",
            "state": "VA",
            "postal_code": "23917",
            "telephone_number": "434-738-6102",
            "fax_number": "434-738-6982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 WASHINGTON ST",
            "city": "BOYDTON",
            "state": "VA",
            "postal_code": "23917",
            "telephone_number": "434-738-6102",
            "fax_number": "434-738-6982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOYDTON COMMUNITY PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DILL",
        "authorized_official_first_name": "CAROL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "434-738-6102"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8506035",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boydton, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.