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General NPI Number Information
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NPI Number | 1962003319
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Entity Type | Individual
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Provider Name | CARLO MIRABELLI R.PH.
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Gender | Male
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Dates
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Enumeration Date | 11/03/2020
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Last Update Date | 05/19/2022
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Provider Practice Location Address
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Address Line | WAL-MART 1028C RICHMOND AVE.
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City | STAUNTON
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State | VA
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Zip | 24401
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Country | US
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Telephone | 540-886-4208
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Fax | 540-886-6205
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Provider Business Mailing Address
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Address Line | 3606 MOFFAT ST
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22902-6250
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Country | US
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Telephone | 143-453-1054
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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 | 0202206534
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License Number State | VA
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