=====================================================
General NPI Number Information
=====================================================
NPI Number | 1265013288
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JULIE B. HUGHES PHARMD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/20/2021
-----------------------------------------------------
Last Update Date | 04/20/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2823 FRANKLIN RD SW
-----------------------------------------------------
City | ROANOKE
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 24014-1027
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-375-5782
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1025 OLE TAYLOR DR
-----------------------------------------------------
City | HARDY
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 24101-4930
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 540-719-2188
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 0202208459
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------