Individual
KIM HART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1906 BELLEVIEW AVE SE, ROANOKE, VA 24014-1838
(540) 853-0961
Mailing address
1906 BELLEVIEW AVE SE, ROANOKE, VA 24014-1838
(540) 853-0961
Taxonomy
Speciality
Code
Description
License number
State
1835X0200X
Oncology Pharmacist
Primary
0202009721
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0202009721
VIRGINIA PHARMACIST LICENSE
VA
01
—
295810
NABP
VA
Enumeration date
11/09/2018
Last updated
11/09/2018
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