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General NPI Number Information
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NPI Number | 1659660561
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Entity Type | Individual
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Provider Name | ALBERT THOMAS MCCONNELL RPH
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Gender | Male
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Dates
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Enumeration Date | 03/31/2011
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Last Update Date | 03/31/2011
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Provider Practice Location Address
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Address Line | 113 E MAIN STREET
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City | SALTVILLE
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State | VA
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Zip | 24370
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Country | US
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Telephone | 276-496-5289
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Fax | 276-496-0233
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Provider Business Mailing Address
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Address Line | 113 E MAIN STREET
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City | SALTVILLE
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State | VA
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Zip | 24370-0967
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Country | US
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Telephone | 276-496-5289
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Fax | 276-496-0233
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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 | 00202005956
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License Number State | VA
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