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General NPI Number Information
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NPI Number | 1942914619
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Entity Type | Individual
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Provider Name | RUND JAMIL SHAKROO BPS
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Gender | Female
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Dates
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Enumeration Date | 01/09/2023
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Last Update Date | 01/09/2023
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Provider Practice Location Address
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Address Line | 9645 WEST BROAD STREET PUBLIX PHARMACY AT
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City | GLEN ALLEN
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State | VA
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Zip | 23060-4116
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Country | US
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Telephone | 804-799-6041
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Fax |
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Provider Business Mailing Address
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Address Line | 10713 CLIFFMORE DRIVE
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City | GLEN ALLEN
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State | VA
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Zip | 23060-6451
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Country | US
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Telephone | 804-617-1872
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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 | 0202214598
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License Number State | VA
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