Healthcare Provider Details

I. General information

NPI: 1548326739
Provider Name (Legal Business Name): FRANK M. LUSK JR. R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 FIG ST
CAPE CHARLES VA
23310-3322
US

IV. Provider business mailing address

PO BOX 1078
CHERITON VA
23316-1078
US

V. Phone/Fax

Practice location:
  • Phone: 757-331-1212
  • Fax: 757-331-1306
Mailing address:
  • Phone: 757-331-1531
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202004982
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: