Servant Pharmacy of Virginia Inc

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

0201004415 Issued in VA

Legal business name

SERVANT PHARMACY OF VIRGINIA INC

Practice address

10370 Battleview Pkwy
Manassas, VA 20109-2338

Phone

(678) 303-1680

Fax

(678) 303-1686

NPI assigned

Aug 29, 2011

Organization subpart

No

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

Authorized official

Name

Randy Angel

Title

Owner/Coo

Phone

(919) 760-5483

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Servant Pharmacy of Virginia Doing business as

Tax ID family

Servant Pharmacy of Virginia2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Servant Pharmacy of Virginia Inc

  • Long Term Care Pharmacy
  • Daleville, VA
  • NPI 1588675078
  NPD tax ID

Locations

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

{
    "created_epoch": "1314576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394582400000",
    "number": "1629359161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2451 CUMBERLAND PKWY SE",
            "address_2": "SUITE 3694",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303396136",
            "telephone_number": "678-303-1680",
            "fax_number": "678-303-1686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10370 BATTLEVIEW PKWY",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201092338",
            "telephone_number": "678-303-1680",
            "fax_number": "678-303-1686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERVANT PHARMACY OF VIRGINIA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-29",
        "last_updated": "2014-03-12",
        "status": "A",
        "authorized_official_last_name": "ANGEL",
        "authorized_official_first_name": "RANDY",
        "authorized_official_title_or_position": "OWNER/COO",
        "authorized_official_telephone_number": "919-760-5483"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "VA",
            "license": "0201004415",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2131606",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Servant Pharmacy of Virginia",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Meera Sethi, M.D.
• Hideki Seto
• Tania Sexton
• Sezer LLC

• Long Term Care Pharmacy in Manassas, VA
• Providers in Manassas, VA by specialty
• Long Term Care Pharmacy in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2014; 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.