Community Phcy of South Boston,Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

0201001935 Issued in VA

Legal business name

COMMUNITY PHCY OF SOUTH BOSTON,INC

Practice address

2202 Beechmont Rd
South Boston, VA 24592-1614

Phone

(434) 575-7988

Fax

(434) 575-1358

NPI assigned

Jul 30, 2006

Organization subpart

No

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

Authorized official

Name

Samuel Fisher

Title

Owner

Phone

(434) 575-7988

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• COMMUNITY PHCY OF SOUTH BOSTON INC Doing business as

Locations

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320624000000",
    "number": "1700891306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 506",
            "city": "SOUTH BOSTON",
            "state": "VA",
            "postal_code": "245920506",
            "telephone_number": "434-575-7988",
            "fax_number": "434-575-1358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2202 BEECHMONT RD",
            "city": "SOUTH BOSTON",
            "state": "VA",
            "postal_code": "245921614",
            "telephone_number": "434-575-7988",
            "fax_number": "434-575-1358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY PHCY OF SOUTH BOSTON,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2011-11-07",
        "status": "A",
        "authorized_official_last_name": "FISHER",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "434-575-7988"
    },
    "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": "0201001935",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "4809628",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8508259",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COMMUNITY PHCY OF SOUTH BOSTON INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in South Boston, VA
• Providers in South Boston, 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 7, 2011; 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.