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General NPI Number Information
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NPI Number | 1659723807
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Entity Type | Individual
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Provider Name | JOHN DAVID GANTHER III PHARMD
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Gender | Male
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Dates
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Enumeration Date | 07/11/2016
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | H-166 US CAPITOL
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City | WASHINGTON
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State | DC
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Zip | 20515-2111
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Country | US
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Telephone | 202-225-9825
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Fax |
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Provider Business Mailing Address
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Address Line | 620 JOHN PAUL JONES CIR
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City | PORTSMOUTH
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State | VA
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Zip | 23708-2111
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Country | US
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Telephone | 757-953-7185
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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 | 0202218773
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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 | A1-0004955
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License Number State | DE
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