Fork Union Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

0201000280 Issued in VA

Legal business name

FORK UNION PHARMACY INC

Doing business as

Fork Union Pharmacy Inc

Practice address

4316 B James Madison Hwy
Fork Union, VA 23055

Phone

(434) 842-3208

Fax

(434) 842-1447

NPI assigned

Jul 25, 2006

Last updated

Oct 4, 2016By 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

Ivan YonceNPI 1780277319

Title

Owner and Pharmacist

Phone

(434) 842-3208

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• FORK UNION PHARMACY INC Doing business as

Medicare fee-for-service enrollment

Enrolled in VA2 enrollments

Enrollment records 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ivan Dane Yonce, RPH

  • Pharmacist
  • Fork Union, VA
  • NPI 1780277319
  NPD Authorized official

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475539200000",
    "number": "1417970880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 187",
            "city": "FORK UNION",
            "state": "VA",
            "postal_code": "230550187",
            "telephone_number": "434-842-3288",
            "fax_number": "434-842-1447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4316 B JAMES MADISON HWY",
            "city": "FORK UNION",
            "state": "VA",
            "postal_code": "23055",
            "telephone_number": "434-842-3208",
            "fax_number": "434-842-1447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORK UNION PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-25",
        "last_updated": "2016-10-04",
        "status": "A",
        "authorized_official_last_name": "YONCE",
        "authorized_official_first_name": "IVAN",
        "authorized_official_title_or_position": "OWNER AND PHARMACIST",
        "authorized_official_telephone_number": "434-842-3208"
    },
    "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": "0201000280",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2102630",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8505357",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1417970880",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FORK UNION PHARMACY INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mackenzie Easton
• Envoy of Fork Union, LLC (Envoy at the Village)
• Roy Fields III
• Fork Union Family Medicine
• Fork Union Medical Associates Inc
• Fork Union SNF Operations LLC (Oakhurst Health & Rehabilitation)
• Jamera DDS PC & Associates
• Karlise in-Home Care, LLC
• Randolph Ewing Lanford, MD
• Linda Staiger MD PC

• Community/Retail Pharmacy in Fork Union, VA
• Providers in Fork Union, 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 Oct 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.