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General NPI Number Information
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NPI Number | 1801060686
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Entity Type | Individual
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Provider Name | FELICIA D DELOATCH PHARMD
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Gender | Female
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Dates
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Enumeration Date | 04/14/2008
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Last Update Date | 04/14/2008
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Provider Practice Location Address
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Address Line | 1532-1556 E. MEMORIAL DR
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City | AHOSKIE
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State | NC
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Zip | 27910-0230
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Country | US
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Telephone | 252-332-3545
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Fax |
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Provider Business Mailing Address
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Address Line | 1118 WOODS PKWY
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City | SUFFOLK
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State | VA
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Zip | 23434-2545
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Country | US
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Telephone | 757-539-9694
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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 | 0202012071
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License Number State | VA
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