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General NPI Number Information
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NPI Number | 1306446877
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Entity Type | Individual
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Provider Name | BRUNO ELIAS ANDRADE RPH
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Gender | Male
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Dates
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Enumeration Date | 10/26/2020
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Last Update Date | 10/26/2020
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Provider Practice Location Address
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Address Line | 3900 WARDS RD
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City | LYNCHBURG
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State | VA
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Zip | 24502-2942
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Country | US
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Telephone | 434-832-0208
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Fax | 434-832-0210
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Provider Business Mailing Address
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Address Line | 306 SPRING LAKE RD
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City | FOREST
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State | VA
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Zip | 24551-1970
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Country | US
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Telephone | 434-426-8449
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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 | 0202212741
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License Number State | VA
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