OrganizationActive
Kmart 4062
NPI 1790148617 · Pharmacy · Danville, VA
Provider details
- NPI number
- 1790148617
- Entity type
- Organization
- Primary specialty
- PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Danny Stevens, Pharmacy Manager(434) 799-0162
- License
- 0202010116 (VA)
Specialties & taxonomies
Suppliers
Profile Score
Established profile(72/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
10 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
3311 Riverside Dr
Danville, VA 24541-3430
Phone: (434) 799-0162
Fax: (847) 396-2798
Street-level locationGet directions
Mailing address
3710 Tom Fork Rd
Ringgold, VA 24586-3844
Registry dates
- Enumerated
- 2016-03-29
- Last updated
- 2016-03-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.