<Unavail>

LBN: Street Drug Corporation
<Unavail> is an health care organization with primary practice located at 110 W Main St , Lebanon VA 24266-4214. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Street Drug Corporation can be contacted via phone (276) 889-1919, or through Street, Ralph via phone (276) 889-1919.

Contact Information

Primary practice address
110 W Main St Lebanon VA 24266-4214
Phone: (276) 889-1919
Fax: (276) 889-4635
Website:
Map and Directions
Authorized official contact:
Name: Street, Ralph RPH
Phone: (276) 889-1919

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 0201002833 Virginia

Profile Details

NPI number 1477534709
LBN Legal business name Street Drug Corporation
DBA Doing business as <Unavail>
Authorized official Street, Ralph RPH
Entity Organization
Organization subpart 1 No
Enumeration date Nov 14th, 2005
Last updated Aug 26th, 2014 - about 12 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 1477534709 NPPES
Virginia MEDICAID 008531315
Virginia Other 2104077

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