Appomattox Drug Store Inc

Key facts

NPI

1508896598

Entity type

Organization (NPI type 2)

Primary specialty

Community/Retail Pharmacy 3336C0003X

License

0201001785 (VA)

Legal business name

APPOMATTOX DRUG STORE INC

Practice address

2046 Confederate Blvd
Appomattox, VA 24522-4097

Phone

(434) 352-7161

Fax

(434) 352-2180

NPI assigned

Jul 4, 2006

Organization subpart

No

Authorized official

Name

Jamie Mitchell

Title

General Manager

Phone

(434) 352-7161

National Provider Directory

Specialties & licenses

Addresses

Other identifiers

Other names

• APPOMATTOX DRUG STORE Doing business as

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 11, 2023.

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702252800000",
    "number": "1508896598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 489",
            "city": "APPOMATTOX",
            "state": "VA",
            "postal_code": "245220489",
            "telephone_number": "434-352-7161",
            "fax_number": "434-352-2180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2046 CONFEDERATE BLVD",
            "city": "APPOMATTOX",
            "state": "VA",
            "postal_code": "245224097",
            "telephone_number": "434-352-7161",
            "fax_number": "434-352-2180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APPOMATTOX DRUG STORE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "434-352-7161"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "VA",
            "license": "0201001785",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008511268",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2102351",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8511268",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "APPOMATTOX DRUG STORE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "APPOMATTOX DRUG STORE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Appomattox, VA

• Aging Well Health and Wellnes
• Appomattox Care Center LLC
• Appomattox County Public Schools
• Appomattox County Rescue Squad Inc
• Appomattox Drug Store
• Sidnei Brianne Arrowood, DPT, PT
• Aspire Mental Health and Wellness LLC
• At Home Service Management, LLC
• Babcock Manor, Inc,
• Allison Brooke Barksdale, DPT

All providers in Appomattox, VA · Community/Retail Pharmacy in Virginia