Healthcare Provider Details

I. General information

NPI: 1689278723
Provider Name (Legal Business Name): JULIET ESCOBAR RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/30/2020
Last Update Date: 11/30/2020
Certification Date: 11/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7023 THREE CHOPT RD
RICHMOND VA
23226-3606
US

IV. Provider business mailing address

11804 WESTCOTT LANDING CT
GLEN ALLEN VA
23059-7077
US

V. Phone/Fax

Practice location:
  • Phone: 804-285-4449
  • Fax:
Mailing address:
  • Phone: 908-399-1297
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202206802
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: