Organization · Type 2 NPI

St. Mary's Pharmacy

Clinic Pharmacy · Wise, VA

NPI number 1255102166 Active

Practice location

5626 Patriot Dr
Wise, VA 24293-1138

Specialties and licenses

Taxonomy	Code	License
Clinic Pharmacy Primary	3336C0002X	None listed

Clinic Pharmacy: A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist.

5 other providers at this address

NPI record

NPI: 1255102166
Entity type: Organization (Type 2)
Issued: Jan 10, 2024
Last updated: Jan 10, 2024
Status: Active
Subpart: Yes of St. Mary's Health Wagon

Other names

St. Mary's Health Wagon · doing business as

Authorized official

Dr. Jennifer Lynden Hammons, PharmD
Pharmacist In Charge
(276) 346-8850

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1255102166

St. Mary's Pharmacy's National Provider Identifier is 1255102166, issued on Jan 10, 2024. The primary taxonomy on file is Clinic Pharmacy (3336C0002X), and the practice location is in Wise, VA. The record was last updated on Jan 10, 2024.