Healthcare Provider Details

I. General information

NPI: 1831220680
Provider Name (Legal Business Name): ANGELA DISE MITCHELL PHARM.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12726 ROUTE 1
CHESTER VA
23831-5370
US

IV. Provider business mailing address

12726 ROUTE 1 PHARMACY DEPARTMENT
CHESTER VA
23831-5370
US

V. Phone/Fax

Practice location:
  • Phone: 804-414-7001
  • Fax:
Mailing address:
  • Phone: 804-414-7001
  • Fax: 804-414-7003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number0202207073
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: