Olde Virginia Pharmacy, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

0201003318 Issued in VA

Legal business name

OLDE VIRGINIA PHARMACY, INC.

Doing business as

Olde Virginia Pharmacy, Inc.

Practice address

1592 Fincastle Tpke
Tazewell, VA 24651-6167

Phone

(276) 988-7977

Fax

(276) 988-7469

NPI assigned

Sep 20, 2006

Last updated

Nov 2, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Scott Cole, PHARMD

Title

Pharmacist/Owner/President

Phone

(276) 988-7977

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Olde Virginia Pharmacy, Inc. Doing business as

Locations

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604275200000",
    "number": "1174620918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 664",
            "city": "TAZEWELL",
            "state": "VA",
            "postal_code": "246510664",
            "telephone_number": "276-988-7977",
            "fax_number": "276-988-1098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1592 FINCASTLE TPKE",
            "city": "TAZEWELL",
            "state": "VA",
            "postal_code": "246516167",
            "telephone_number": "276-988-7977",
            "fax_number": "276-988-7469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLDE VIRGINIA PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-11-02",
        "certification_date": "2020-08-24",
        "status": "A",
        "authorized_official_last_name": "COLE",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "PHARMACIST/OWNER/PRESIDENT",
        "authorized_official_telephone_number": "276-988-7977",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "VA",
            "license": "0201003318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2106896",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8507473",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Olde Virginia Pharmacy, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shelby Leigh Mutter, DPT
• Rachael Myers, MSW-S
• Sara Necessary, RN, BSN, MBA
• Katie Newsome-Deel, APRN
• Ikenna S. Nzeogu, D.O.
• Ladonna Lee Osborne, CFNP
• Pablo M Carpio, MD, PC
• Tristen Amber Pack, PA-C
• Queenasia Marie Padgett
• Deborah Parsons

• Community/Retail Pharmacy in Tazewell, VA
• Providers in Tazewell, VA by specialty
• Community/Retail Pharmacy in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 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.