Healthcare Provider Details

I. General information

NPI: 1104739812
Provider Name (Legal Business Name): PRIYANKA PRAJAPATI RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11271 NUCKOLS RD
GLEN ALLEN VA
23059-5502
US

IV. Provider business mailing address

11409 GREY OAKS ESTATES RUN
GLEN ALLEN VA
23059-5923
US

V. Phone/Fax

Practice location:
  • Phone: 804-217-8881
  • Fax:
Mailing address:
  • Phone: 682-225-5314
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202223685
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: