Organization Name: | JAMESTOWN FAMILY PHARMACY INC |
NPI Number: | 1043601560 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JIMMY DALE KEITH (PRESIDENT) |
Mailing Address: | 2905 Darrow Rd Walkertown |
State: | NC US |
Postal Code: | 270519682 |
Phone Number: | 3365956979 |
Fax Number: | 3365957079 |
NPI Enumeration Date: | 02/06/2015 |
NPI Last Update Date: | 02/06/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QC1500X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Community Health |
Taxonomy Definition: |