Centertown Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

CENTERTOWN PHARMACY LLC

Doing business as

EAST LAKE PHARMACY

Practice address

10102 Leesville Rd
Lynch Station, VA 24571-2210

Phone

(540) 587-0555

Fax

(540) 587-8741

NPI assigned

Jun 12, 2006

Organization subpart

No

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

Authorized official

Name

G Bruce Thompson, RPH

Title

GM

Phone

(540) 587-0555

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• EAST LAKE PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1841232147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10102 LEESVILLE RD",
            "city": "LYNCH STATION",
            "state": "VA",
            "postal_code": "245712210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10102 LEESVILLE RD",
            "city": "LYNCH STATION",
            "state": "VA",
            "postal_code": "245712210",
            "telephone_number": "540-587-0555",
            "fax_number": "540-587-8741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTERTOWN PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-12",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "G BRUCE",
        "authorized_official_title_or_position": "GM",
        "authorized_official_telephone_number": "540-587-0555",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "VA",
            "license": "0201004056",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "4839049",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EAST LAKE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mary Amanda Bullington, CCC-SLP
• Amy E. Johnson, DNP, FNP-C
• Purposeful Play Pediatric Therapies LLC
• Amanda Thompson

• Community/Retail Pharmacy in Lynch Station, VA
• Providers in Lynch Station, 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 Sep 11, 2025; 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.