Individual
MR. CHARLES SAMUEL AVERETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
240 BROAD ST, DUBLIN, VA 24084-3203
(540) 674-5261
(540) 674-5154
Mailing address
240 BROAD ST, DUBLIN, VA 24084-3203
(540) 674-5261
(540) 674-5154
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202004444
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1205071735
—
VA
Enumeration date
09/05/2011
Last updated
09/05/2011
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