Individual
DR. AUTUMN LARGE-FOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH, PHARM.D., CDE
Contact information
Practice address
14 E 27TH ST N, SUITE 1, BIG STONE GAP, VA 24219-3624
(276) 523-1713
(276) 523-2931
Mailing address
PO BOX 777, BIG STONE GAP, VA 24219-0777
(276) 523-1713
(276) 523-2931
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202206469
VA
183500000X
Pharmacist
16915
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0202206469
PHARMACIST LICENSE NUMBER
VA
01
—
16915
NORTH CAROLINA PHARMACIST
NC
Enumeration date
07/29/2005
Last updated
08/01/2023
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