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General NPI Number Information
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NPI Number | 1679210181
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Entity Type | Organization
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Legal Business Name | NEIGHBORCARE, PLLC
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Dates
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Enumeration Date | 05/16/2022
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Last Update Date | 06/21/2022
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Provider Practice Location Address
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Address Line | 3133 YARDLEY DR NW
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City | ROANOKE
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State | VA
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Zip | 24012-2309
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Country | US
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Telephone | 540-330-4455
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Fax |
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Provider Business Mailing Address
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Address Line | 3133 YARDLEY DR NW
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City | ROANOKE
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State | VA
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Zip | 24012-2309
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Country | US
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Telephone | 540-330-4455
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITONER
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Name | MR. JASON PATRICK ITSON SR.
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Credential | MSN, AGACNP-BC
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Telephone | 540-330-4455
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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