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General NPI Number Information
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NPI Number | 1518249465
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Entity Type | Individual
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Provider Name | VISHAL TRIVEDI
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Gender | Male
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Dates
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Enumeration Date | 09/16/2011
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Last Update Date | 09/16/2011
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Provider Practice Location Address
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Address Line | 2707 GREENSBORO RD
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City | MARTINSVILLE
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State | VA
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Zip | 24112-9104
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Country | US
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Telephone | 276-632-0180
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Fax |
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Provider Business Mailing Address
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Address Line | 3464 COLONIAL AVE APARTMENT# B-10
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City | ROANOKE
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State | VA
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Zip | 24018-4567
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Country | US
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Telephone |
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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 | 0202209167
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License Number State | VA
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