APPOMATTOX DRUG STORE NPI 1679622948

NPI Information

  • NPI: 1679622948
  • Provider Name: APPOMATTOX DRUG STORE
  • Classification: Durable Medical Equipment & Medical Supplies - 332B00000X
  • Entity Type: Organization
  • CLIA Number: 49D1072621
  • Address: 2046 CONFEDERATE BLVD
    APPOMATTOX, VA
    ZIP 24522
  • Phone: (434) 352-7161

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NPI Details

APPOMATTOX DRUG STORE is a durable medical equipment medical supplies in Appomattox, VA. The provider is a supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time. APPOMATTOX DRUG STORE NPI is 1679622948. The provider is registered as an organization entity type.

The provider's business location address is:

2046 CONFEDERATE BLVD
APPOMATTOX, VA
ZIP 24522-097
Phone: (434) 352-7161
Fax: (434) 352-9466

The provider's authorized official is Jamie D Mitchell .
The authorized official title is General Manager and has the following contact phone number (434) 352-7161.

The CLIA number assigned to this NPI record is 49D1072621 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/9/2007 and was last updated on 12/11/2023.

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
1332B00000XDurable Medical Equipment & Medical SuppliesVIRGINIAYes

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
1009106545MEDICAIDVIRGINIA

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: 3/30/2025

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