Individual
KENNETH L HEARN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
5802 W BROAD ST, RICHMOND, VA 23230-2659
(804) 288-3191
(804) 288-3134
Mailing address
5802 W BROAD ST, RICHMOND, VA 23230-2659
(804) 288-3191
(804) 288-3134
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202005487
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0202005487
COMMONWEALTH OF VIRGINA DEPARTMENT OF HEALTH PROFESSIONS
VA
Enumeration date
12/17/2011
Last updated
12/17/2011
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