Maysons Pharmacy at Retreat

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

MAYSONS PHARMACY AT RETREAT

Doing business as

Maysons Pharmacy at Retreat

Practice address

110 N Robinson St Ste 101
Richmond, VA 23220-4459

Phone

(804) 658-1080

NPI assigned

Oct 23, 2020

Organization subpart

No

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

Authorized official

Name

Mr. Scott Kim

Title

Manager

Phone

(703) 622-0376

Specialties & licenses 1

Addresses

Other names 1

• MAYSONS PHARMACY AT RETREAT Doing business as

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

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

{
    "created_epoch": "1603411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629417600000",
    "number": "1730788381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 N ROBINSON ST STE 101",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232204459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 N ROBINSON ST STE 101",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232204459",
            "telephone_number": "804-658-1080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAYSONS PHARMACY AT RETREAT",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-23",
        "last_updated": "2021-08-20",
        "certification_date": "2021-08-20",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "703-622-0376",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MAYSONS PHARMACY AT RETREAT",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MAYSONS PHARMACY AT RETREAT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ellen Nicole-Boone Mayo, BCABA, LABA
• Haripreet Mayo
• Luke Mayo
• Matthew Thomas Mayr, M.D.
• Jacquelyn Elizabeth Mays, SURGICAL ASSISTANT
• Jamine Mayton
• Mazie's Mane & More, LLC
• Lauren Nicole Mazin, DO
• Michael Mazurek III, PA-C
• Tricia Mazza

• Community/Retail Pharmacy in Richmond, VA
• Providers in Richmond, 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 Aug 20, 2021; 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.