Logan James Adkisson
Individual provider Active NPI Pharmacist · Centreville, VA
NPI 1982476263 · NPPES record last updated Oct 30, 2023
Key facts
- NPI
- 1982476263
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 0202221668 (VA)
- Practice address
- 14125 Saint Germain Dr
Centreville, VA 20121-2310 - Phone
- (703) 631-7720
- NPI assigned
- Oct 30, 2023
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0202221668 | VA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Giant of Maryland LLC | Past |
Accepting new patients | |
| Giant of Maryland LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0202221668 | VA | Yes |
Addresses
Primary practice location
14125 Saint Germain Dr
Centreville, VA 20121-2310
Mailing address
5806 Stream Pond CT
Centreville, VA 20120-5421
Other providers in Centreville, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 30, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.