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General NPI Number Information
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NPI Number | 1700373982
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Entity Type | Individual
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Provider Name | BRENDA D CARPENTER RPH
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Gender | Female
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Dates
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Enumeration Date | 04/13/2018
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Last Update Date | 04/13/2018
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Provider Practice Location Address
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Address Line | 3650 JOSEPH SIEWICK DR
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City | FAIRFAX
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State | VA
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Zip | 22033-1710
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Country | US
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Telephone | 703-391-2032
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Fax |
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Provider Business Mailing Address
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Address Line | 9757 LORRAINE CAROL WAY
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City | LORTON
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State | VA
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Zip | 22079-2135
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Country | US
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Telephone | 414-704-7506
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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 | 0202206847
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License Number State | VA
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