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General NPI Number Information
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NPI Number | 1891728440
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Entity Type | Organization
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Legal Business Name | COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH
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Dates
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Enumeration Date | 07/08/2006
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Last Update Date | 09/18/2018
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Provider Practice Location Address
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Address Line | 101 N 14TH ST MONROE BLDG., ROOM S-45
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City | RICHMOND
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State | VA
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Zip | 23219-3665
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Country | US
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Telephone | 804-786-1652
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Fax | 804-371-0236
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Provider Business Mailing Address
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Address Line | PO BOX 2448
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City | RICHMOND
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State | VA
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Zip | 23218-2448
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Country | US
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Telephone | 804-786-1652
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Fax | 804-371-0236
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Authorized Official
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Title or Position | DIRECTOR
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Name | STEPHANIE WHEAWILL
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Credential | PHARMD
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Telephone | 804-786-4326
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 0201000080
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License Number State | VA
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