Healthcare Provider Details

I. General information

NPI: 1114033982
Provider Name (Legal Business Name): DEBORAH ANN QUARLES PHARM. D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

DAYTON VAMC 4100 W. THIRD ST.
DAYTON OH
45428
US

IV. Provider business mailing address

2151 DELVUE DR
DAYTON OH
45459-3623
US

V. Phone/Fax

Practice location:
  • Phone: 937-268-6511
  • Fax:
Mailing address:
  • Phone: 937-438-5476
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number03-2-17788
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: