Healthcare Provider Details

I. General information

NPI: 1104945401
Provider Name (Legal Business Name): EMORY F HURST JR. RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 MARKET ST
ONANCOCK VA
23417-1911
US

IV. Provider business mailing address

24150 THICKET POINT LN
ONANCOCK VA
23417-3034
US

V. Phone/Fax

Practice location:
  • Phone: 757-787-3500
  • Fax: 757-787-9449
Mailing address:
  • Phone: 757-789-3845
  • Fax: 757-787-9449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202005250
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: