GREEN WAVE PHARMACY INC NPI 1285671750

NPI Information

  • NPI: 1285671750
  • Provider Name: GREEN WAVE PHARMACY INC
  • Classification: Pharmacy - 3336C0003X
  • Specialization: Community/Retail Pharmacy
  • Entity Type: Organization
  • Address: 165 MCCLURE AVE
    CLINTWOOD, VA
    ZIP 24228
  • Phone: (276) 926-4733

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NPI Details

GREEN WAVE PHARMACY INC is a community/retail pharmacy pharmacy in Clintwood, VA. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. GREEN WAVE PHARMACY INC NPI is 1285671750. The provider is registered as an organization entity type.

The provider's business location address is:

165 MCCLURE AVE
CLINTWOOD, VA
ZIP 24228-845
Phone: (276) 926-4733
Fax: (276) 926-5137

The provider's authorized official is Sheryl Dawn Pientka .
The authorized official title is Pharmacist In Charge and has the following contact phone number (276) 926-4733.

The enumeration date for this NPI number is 6/1/2006 and was last updated on 8/5/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
13336C0003XPharmacyCommunity/Retail Pharmacy0201002056VIRGINIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11140100001MEDICARE ID-TYPE UNSPECIFIED
2008514186MEDICAIDVIRGINIA
34818398OTHERNABP

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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