Individual
MRS. KIMBERLY A MCCALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
204 SHADY AVE, DAMASCUS, VA 24236
(276) 475-5022
(275) 475-3614
Mailing address
PO BOX 384, DAMASCUS, VA 24236-0384
(276) 475-3224
(276) 475-3614
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
0000013124
TN
183500000X
Pharmacist
Primary
0202206209
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000013124
TENNESSEE PHARMACIST LICENSE NUMBER
TN
01
—
0202206209
VIRGINIA PHARMACIST LICENSE NUMBER
VA
Enumeration date
05/19/2008
Last updated
05/19/2008
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