Healthcare Provider Details

I. General information

NPI: 1023860137
Provider Name (Legal Business Name): KAYLA PANGILINAN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2024
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3507 W CARY ST
RICHMOND VA
23221-2728
US

IV. Provider business mailing address

5001 LIBBIE MILL EAST BLVD APT 280
RICHMOND VA
23230-2135
US

V. Phone/Fax

Practice location:
  • Phone: 804-254-6400
  • Fax:
Mailing address:
  • Phone: 757-641-5386
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number0202221432
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: