Healthcare Provider Details

I. General information

NPI: 1366437436
Provider Name (Legal Business Name): ANGELA DYER PHARM. D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6800 PARAGON PL SUITE 300
RICHMOND VA
23230-1649
US

IV. Provider business mailing address

4503 FITZHUGH AVE
RICHMOND VA
23230-3730
US

V. Phone/Fax

Practice location:
  • Phone: 804-678-2000
  • Fax: 804-354-4655
Mailing address:
  • Phone: 804-213-0506
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202206222
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: