Provider Demographics
NPI:1629721071
Name:GILES PHARMACY INC
Entity type:Organization
Organization Name:GILES PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SENTHIL
Authorized Official - Middle Name:GANESH
Authorized Official - Last Name:MARIMUTHU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-552-3000
Mailing Address - Street 1:2903 COMMERCE ST STE E
Mailing Address - Street 2:
Mailing Address - City:BLACKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24060-6602
Mailing Address - Country:US
Mailing Address - Phone:540-921-3000
Mailing Address - Fax:540-921-3005
Practice Address - Street 1:1615 WENONAH AVE
Practice Address - Street 2:
Practice Address - City:PEARISBURG
Practice Address - State:VA
Practice Address - Zip Code:24134-1839
Practice Address - Country:US
Practice Address - Phone:540-921-3000
Practice Address - Fax:540-921-3002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-26
Last Update Date:2025-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1629721071Medicaid