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NPI Code Detail

MEDICARE: MALCOLM L HUMPHRIES PHARM.D

MEDICARE:   MALCOLM L HUMPHRIES  PHARM.D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist0202208009VA

General Provider Information

NPI Number : 1427361153
Entity Type Code : Individual
Provider Name (Legal Business Name) : MALCOLM L HUMPHRIES PHARM.D
Provider Business Mailing Address
First Line : 13007 WARWICK BLVD
Second Line :
City : NEWPORT NEWS
State : VA
Zip : 23602-8315
Country : US
Telephone Number : 757-882-1074
Fax Number : 757-882-1075
Provider Business Practice Location Address
First Line : 13007 WARWICK BLVD
Second Line :
City : NEWPORT NEWS
State : VA
Zip : 23602-8315
Country : US
Telephone Number : 757-882-1074
Fax Number : 757-882-1075
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/22/2010
Last Update Date : 01/29/2015

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Directions to “ MALCOLM L HUMPHRIES PHARM.D” Practice Location

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