Healthcare Provider Details

I. General information

NPI: 1598069452
Provider Name (Legal Business Name): ERIC BRYNER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2011
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1356 GASKINS RD
RICHMOND VA
23238-4919
US

IV. Provider business mailing address

1356 GASKINS RD
RICHMOND VA
23238-4919
US

V. Phone/Fax

Practice location:
  • Phone: 804-740-0011
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number0202206261
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: