Individual
MARY EVAN JANINE BASCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1704 EDWARDS AVE, RICHMOND, VA 23224-5228
(571) 344-9185
Mailing address
1704 EDWARDS AVE, RICHMOND, VA 23224-5228
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
0203021471
VA
Other
Enumeration date
08/08/2026
Last updated
08/08/2026
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