GREEN WAVE PHARMACY INC
165 Mcclure Ave
Clintwood, VA 24228
276-926-4733
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 3336C0003X | Suppliers - Pharmacy - Community/Retail Pharmacy | VA | 0201002056 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
NABP | 4818398 | OTHER | |
008514186 | VA | MEDICAID |