Powhatan Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

0201001368 Issued in VA

Legal business name

POWHATAN PHARMACY INC

Practice address

1799 Southcreek One
Ste a
Powhatan, VA 23139-7960

Phone

(804) 379-6986

Fax

(804) 379-1086

NPI assigned

Jun 15, 2005

Last updated

Jun 1, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gina Thompson

Title

Pharmacy Director

Phone

(804) 379-6986

Specialties & licenses 2

Addresses

Other identifiers 5

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mary Therese Shepperson, RPH

  • Pharmacist
  • Powhatan, VA
  • NPI 1902932387
  NPD (past)

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

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433116800000",
    "number": "1952306052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1799 SOUTHCREEK ONE",
            "address_2": "STE L",
            "city": "POWHATAN",
            "state": "VA",
            "postal_code": "231397960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1799 SOUTHCREEK ONE",
            "address_2": "STE A",
            "city": "POWHATAN",
            "state": "VA",
            "postal_code": "231397960",
            "telephone_number": "804-379-6986",
            "fax_number": "804-379-1086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POWHATAN PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-15",
        "last_updated": "2015-06-01",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "GINA",
        "authorized_official_title_or_position": "PHARMACY DIRECTOR",
        "authorized_official_telephone_number": "804-379-6986"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "VA",
            "license": "0201001368",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "VA",
            "license": "0201001368",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE FLU",
            "identifier": "00022F",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008510644",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009138854",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "4808361",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00231424",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Powhatan County Board of Supervisors (Powhatan Fire and Rescue Department)
• Powhatan Family Counseling and Education Center
• Powhatan Family Physicians, LTD
• Powhatan Gentle Dentistry
• Powhatan Gentle Dentistry PLC
• Powhatan Physical Therapy Corporation
• Powhatan RX LLC (Powhatan Drug)
• Powhatan Volunteer Rescue Squad, Inc.
• Premier Wellness Consultants
• Premieremed LLC (Clementson Medical)

• Community/Retail Pharmacy in Powhatan, VA
• Providers in Powhatan, 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 Jun 1, 2015; 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.