Healthcare Provider Details

I. General information

NPI: 1114527595
Provider Name (Legal Business Name): JANEEN RENEE THALMAN RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2020
Last Update Date: 10/27/2020
Certification Date: 10/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 WASHINGTON SQUARE PLZ
FREDERICKSBURG VA
22405-3235
US

IV. Provider business mailing address

6294 AUTUMN LEAF DR
FREDERICKSBURG VA
22407-7205
US

V. Phone/Fax

Practice location:
  • Phone: 540-899-8951
  • Fax:
Mailing address:
  • Phone: 540-359-5082
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202012469
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: