Individual
MR. JOHN W BASS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
4121 HALIFAX ROAD, SOUTH BOSTON, VA 24592
(434) 575-0511
(434) 575-1366
Mailing address
PO BOX 788, 469 LAKESIDE DRIVE, HALIFAX, VA 24558
(434) 476-6629
(434) 575-1366
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202003779
VA
Other
Enumeration date
11/15/2006
Last updated
07/08/2007
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