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General NPI Number Information
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NPI Number | 1124566153
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Entity Type | Individual
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Provider Name | TIFFANY ROSS RPH
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Gender | Female
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Dates
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Enumeration Date | 02/10/2017
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Last Update Date | 02/10/2017
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Provider Practice Location Address
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Address Line | 7789 RICHMOND HWY
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City | APPOMATTOX
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State | VA
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Zip | 24522-8680
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Country | US
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Telephone | 434-352-0817
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Fax |
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Provider Business Mailing Address
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Address Line | 301 NORTHWYND CIR APT 203
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City | LYNCHBURG
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State | VA
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Zip | 24502-3448
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Country | US
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Telephone | 740-464-6818
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0202214244
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License Number State | VA
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