Individual
NHOC SEMUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14101 MIDLOTHIAN TPKE, MIDLOTHIAN, VA 23113-6523
(804) 594-1645
Mailing address
2014 DEER MEADOW LN, MIDLOTHIAN, VA 23112-4134
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202207298
VA
Other
Enumeration date
12/09/2010
Last updated
12/09/2010
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