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Individual

MR. ANTHONY TODD STAINBACK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
600 GRESHAM DRIVE, NORFOLK, VA 23507
(757) 388-1204
(757) 388-1202
Mailing address
801 PONCE COURT, CHESAPEAKE, VA 23322
(757) 482-2844
(757) 388-1202

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202007614
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0202007614
PHARMACIST LICENSE
VI
Enumeration date
05/01/2007
Last updated
07/08/2007
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