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General NPI Number Information
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NPI Number | 1477020691
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Entity Type | Individual
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Provider Name | PATRICK JOSEPH PEKALA PHARMD
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Gender | Male
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Dates
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Enumeration Date | 10/25/2018
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Last Update Date | 10/25/2018
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Provider Practice Location Address
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Address Line | 1906 BELLEVIEW AVE SE
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City | ROANOKE
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State | VA
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Zip | 24014-1838
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Country | US
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Telephone | 540-266-6671
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Fax |
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Provider Business Mailing Address
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Address Line | 451 KIMBALL AVE NE
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City | ROANOKE
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State | VA
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Zip | 24016-2101
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Country | US
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Telephone | 540-224-4154
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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 | RP045163L
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License Number State | PA
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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 | 0202206555
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License Number State | VA
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