Healthcare Provider Details

I. General information

NPI: 1801184361
Provider Name (Legal Business Name): JOSEPH E YEAGER RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2011
Last Update Date: 07/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2929 STUARTS DRAFT HWY SUITE 101
STUARTS DRAFT VA
24477-2753
US

IV. Provider business mailing address

PO BOX 791 2929 STUARTS DRAFT HWY SUITE 101
STUARTS DRAFT VA
24477-0791
US

V. Phone/Fax

Practice location:
  • Phone: 540-337-3776
  • Fax: 540-337-2795
Mailing address:
  • Phone: 540-337-3776
  • Fax: 540-337-2795

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202005542
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: