Healthcare Provider Details

I. General information

NPI: 1588224729
Provider Name (Legal Business Name): LAUREN G PAMULAPATI PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2019
Last Update Date: 06/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4730 N SOUTHSIDE PLAZA ST
RICHMOND VA
23224-1742
US

IV. Provider business mailing address

410 N 12TH STREET P.O. BOX 980533
RICHMOND VA
23298
US

V. Phone/Fax

Practice location:
  • Phone: 804-230-7777
  • Fax:
Mailing address:
  • Phone: 804-828-9199
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number0202214017
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: