Healthcare Provider Details

I. General information

NPI: 1255081832
Provider Name (Legal Business Name): SARAH CHANDLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2022
Last Update Date: 03/25/2022
Certification Date: 03/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4121 HALIFAX RD
SOUTH BOSTON VA
24592-4833
US

IV. Provider business mailing address

606 FOREST DR
SOUTH BOSTON VA
24592-1626
US

V. Phone/Fax

Practice location:
  • Phone: 434-575-0511
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202219808
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: