Bull Run Professional Pharmacy

LBN: Amity Health Inc
Bull Run Professional Pharmacy is an health care organization with primary practice located at 9210 Church St Ste 100 , Manassas VA 20110-5524. The organization recently has only one registered license in Suppliers / Community/Retail Pharmacy, which is considered as the primary health care specialty. Amity Health Inc can be contacted via phone (571) 357-4818, or through Vantikommu, Vasumathi via phone (703) 568-2835.

Contact Information

Primary practice address
9210 Church St Ste 100 Manassas VA 20110-5524
Phone: (571) 357-4818
Fax: (703) 782-9393
Website:
Map and Directions
Authorized official contact:
Name: Vantikommu, Vasumathi
Phone: (703) 568-2835

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X 0201004763 Virginia
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1881128544
LBN Legal business name Amity Health Inc
DBA Doing business as Bull Run Professional Pharmacy
Authorized official Vantikommu, Vasumathi
Entity Organization
Organization subpart 1 No
Enumeration date Apr 19th, 2017
Last updated Dec 8th, 2021 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881128544 NPPES
Virginia MEDICAID 2017136935
Virginia Other 2168741

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