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FORK UNION PHARMACY INC NPI 1417970880


NPI Information

NPI: 1417970880
Provider Name: FORK UNION PHARMACY INC

Doing Business As: FORK UNION PHARMACY INC

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

CLIA Number: 49D2153015

Address:
4316 B JAMES MADISON HWY
FORK UNION, VA
ZIP 23055
Phone: (434) 842-3208
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FORK UNION PHARMACY INC is a community/retail pharmacy pharmacy in Fork Union, 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. FORK UNION PHARMACY INC NPI is 1417970880. The provider is registered as an organization entity type.
The provider Is Doing Business As Fork Union Pharmacy Inc.

The provider's business location address is:

4316 B JAMES MADISON HWY
FORK UNION, VA
ZIP 23055
Phone: (434) 842-3208
Fax: (434) 842-1447

The provider's authorized official is Ivan Yonce .
The authorized official title is Owner And Pharmacist and has the following contact phone number (434) 842-3208.

The CLIA number assigned to this NPI record is 49D2153015 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/25/2006 and was last updated on 10/4/2016.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1333600000XPharmacyNo
23336C0003XPharmacyCommunity/Retail Pharmacy0201000280VIRGINIAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
12102630OTHERPK
28505357MEDICAIDVIRGINIA
3371350001MEDICARE PIN
41417970880MEDICAIDVIRGINIA

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: 4/28/2024

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