Healthcare Provider Details

I. General information

NPI: 1982781514
Provider Name (Legal Business Name): BRUCE R BRIGGS II RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

565 RADIO HILL RD SCCH DEPT. OF PHARMACY
MARION VA
24354-6587
US

IV. Provider business mailing address

321 COLLEGE ST
MARION VA
24354-2401
US

V. Phone/Fax

Practice location:
  • Phone: 276-782-1145
  • Fax:
Mailing address:
  • Phone: 276-782-1145
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202009692
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: