Individual
JENNIFER BOPHACHAN TEP-CUADRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1200 N MAIN ST, SUFFOLK, VA 23434-4321
(757) 925-0580
Mailing address
14192 CHAPMANS LN, CARROLLTON, VA 23314-9718
(757) 560-6466
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202206229
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
228003
NABP-E
VA
Enumeration date
04/23/2007
Last updated
12/29/2017
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