Healthcare Provider Details

I. General information

NPI: 1871646513
Provider Name (Legal Business Name): RECTOR & VISITORS OF THE UNIVERSITY OF VIRGINIA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 03/27/2024
Certification Date: 03/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 LEE ST
CHARLOTTESVILLE VA
22908-0816
US

IV. Provider business mailing address

PO BOX 800674
CHARLOTTESVILLE VA
22908-0674
US

V. Phone/Fax

Practice location:
  • Phone: 434-924-2708
  • Fax: 434-982-4197
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number0201009724
License Number StateVA

VIII. Authorized Official

Name: WENDY HORTON
Title or Position: CEO
Credential: RPH
Phone: 434-243-9308