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General NPI Number Information
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NPI Number | 1285205757
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Entity Type | Individual
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Provider Name | GRACE LIMBAUGH
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Gender | Female
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Dates
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Enumeration Date | 07/06/2021
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Last Update Date | 07/06/2021
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Provider Practice Location Address
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Address Line | 7864 RICHMOND TAPPAHANNOCK HWY
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City | AYLETT
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State | VA
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Zip | 23009-3056
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Country | US
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Telephone | 504-769-2015
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Fax | 804-769-2014
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Provider Business Mailing Address
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Address Line | 10103 CONTESSA DR
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City | GLEN ALLEN
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State | VA
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Zip | 23060-3706
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Country | US
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Telephone | 804-755-7153
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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 | 0202007507
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License Number State | VA
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