Individual
MR. MARK PAUL CHABOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
2415 LEE STREET PHARMACY- 800674, CHARLOTTESVILLE, VA 22908-0001
(434) 465-5784
Mailing address
87 MISTLAND TRL, RUCKERSVILLE, VA 22968-3094
(434) 962-3803
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
03314176
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0202-012862
VSBOP
VA
01
—
03314176
OSBOP
OH
Enumeration date
05/03/2019
Last updated
05/03/2019
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