Mt Jackson Drug Store

LBN: Mt Jackson Drug Store Inc
Mt Jackson Drug Store is an health care organization with primary practice located at 5350 Main St , Mount Jackson VA 22842-9511. The organization recently has 4 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Mt Jackson Drug Store Inc can be contacted via phone (540) 477-3101, or through Fansler, James via phone (540) 477-3101.

Contact Information

Primary practice address
5350 Main St Mount Jackson VA 22842-9511
Phone: (540) 477-3101
Fax: (540) 477-4039
Website:
Map and Directions
Authorized official contact:
Name: Fansler, James
Phone: (540) 477-3101

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 0201002587 Virginia
Suppliers / Compounding Pharmacy 3336C0004X

Profile Details

NPI number 1346322120
LBN Legal business name Mt Jackson Drug Store Inc
DBA Doing business as Mt Jackson Drug Store
Authorized official Fansler, James
Entity Organization
Organization subpart 1 No
Enumeration date Oct 20th, 2006
Last updated Aug 16th, 2016 - about 10 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 1346322120 NPPES
Other 2102235 PK
MEDICAID 010078059 PK

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