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General NPI Number Information
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NPI Number | 1780235739
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Entity Type | Organization
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Legal Business Name | OTR FIRMS
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Dates
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Enumeration Date | 09/20/2019
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Last Update Date | 09/20/2019
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Provider Practice Location Address
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Address Line | 600 CHURCH ST RM 141
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City | NORFOLK
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State | VA
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Zip | 23501-9908
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Country | US
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Telephone | 252-389-9082
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 141
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City | NORFOLK
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State | VA
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Zip | 23501-0141
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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 | MANAGER
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Name | KEANAN HENDERSON
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Credential |
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Telephone | 252-389-9082
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336M0002X
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Taxonomy Name | Mail Order Pharmacy
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License Number |
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License Number State |
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