Stephen Michael Johnson
Organization Active NPI Pharmacy · Duffield, VA
NPI 1477586642 · NPPES record last updated Mar 6, 2013
Key facts
- NPI
- 1477586642
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacy 333600000X
- License
- 0201003487 (VA)
- Legal business name
- STEPHEN MICHAEL JOHNSON
- Practice address
- 443 Duff Patt Hwy
Suite 104
Duffield, VA 24244-5191 - Phone
- (276) 431-2299
- Fax
- (276) 431-2191
- NPI assigned
- Jul 9, 2006
- Organization subpart
- No
Authorized official
- Name
- Stephen Michael Johnson, RPH
- Title
- Owner and Pic
- Phone
- (276) 431-2299
National Provider Directory
Locations
443 Duff Patt Hwy
#104
Duffield, VA 24244
Phone (276) 431-2299
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | 0201003487 | VA | Yes |
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
443 Duff Patt Hwy
Suite 104
Duffield, VA 24244-5191
Mailing address
PO Box 383
Duffield, VA 24244-0383
Phone (276) 431-2299
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4832475 | Other | OTHER ID NUMBER | |
| 008514011 | Medicaid | VA | |
| VA8514011 | Medicaid | VA |
Other names
- Village Pharmacy
Other providers in Duffield, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 6, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.