Healthcare Provider Details

I. General information

NPI: 1275069122
Provider Name (Legal Business Name): HARRISONBURG ROCKINGHAM FREE CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2017
Last Update Date: 05/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 W WATER ST
HARRISONBURG VA
22801-3624
US

IV. Provider business mailing address

25 W WATER ST
HARRISONBURG VA
22801-3624
US

V. Phone/Fax

Practice location:
  • Phone: 540-433-5431
  • Fax: 540-574-0207
Mailing address:
  • Phone: 540-433-5431
  • Fax: 540-574-0207

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number0201002981
License Number StateVA

VIII. Authorized Official

Name: BRANDY PIERCE LOWERY
Title or Position: PHARMACIST IN CHARGE
Credential: PHARMD
Phone: 540-433-5431