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General NPI Number Information
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NPI Number | 1437447083
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Entity Type | Individual
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Provider Name | PHILLIP BALL PHARM. D
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Gender | Male
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Dates
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Enumeration Date | 07/18/2011
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Last Update Date | 07/18/2016
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Provider Practice Location Address
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Address Line | 4404 BRAMBLETON AVE
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City | ROANOKE
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State | VA
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Zip | 24018-3427
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Country | US
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Telephone | 540-776-0050
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Fax |
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Provider Business Mailing Address
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Address Line | 7211 NANDINA DR
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City | ROANOKE
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State | VA
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Zip | 24018-5801
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Country | US
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Telephone | 540-314-8766
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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 | 0202206271
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP0007211
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License Number State | WV
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