Healthcare Provider Details

I. General information

NPI: 1447378153
Provider Name (Legal Business Name): MARY JANE HILDEBRAND RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 11/30/2022
Certification Date: 11/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1942 PORT REPUBLIC RD
ROCKINGHAM VA
22801-3532
US

IV. Provider business mailing address

341 OHIO AVE
HARRISONBURG VA
22801-1834
US

V. Phone/Fax

Practice location:
  • Phone: 540-282-6950
  • Fax:
Mailing address:
  • Phone: 540-209-0183
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202208139
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: