Healthcare Provider Details

I. General information

NPI: 1871166546
Provider Name (Legal Business Name): JEFFREY L RUTIG BS, RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2021
Last Update Date: 07/21/2021
Certification Date: 07/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 TYLER RD STE 1890
CHRISTIANSBURG VA
24073-6374
US

IV. Provider business mailing address

2900 TYLER RD STE 1890
CHRISTIANSBURG VA
24073-6374
US

V. Phone/Fax

Practice location:
  • Phone: 540-639-1647
  • Fax: 540-639-0151
Mailing address:
  • Phone: 540-639-1647
  • Fax: 540-639-0151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202007327
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: