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NPI Code Detail

MEDICARE: MR. JOHN ANDREW NEIDERER R.PH.

MEDICARE: MR. JOHN ANDREW NEIDERER R.PH.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist0202010093VA

General Provider Information

NPI Number : 1316923527
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOHN ANDREW NEIDERER R.PH.
Provider Business Mailing Address
First Line : 3556 GREGORY LN
Second Line :
City : LYNCHBURG
State : VA
Zip : 24503-3208
Country : US
Telephone Number : 434-947-2081
Fax Number : 434-947-2368
Provider Business Practice Location Address
First Line : 521 COLONY RD
Second Line :
City : MADISON HEIGHTS
State : VA
Zip : 24572-2105
Country : US
Telephone Number : 434-947-2081
Fax Number : 434-947-2368
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/20/2005
Last Update Date : 07/08/2007

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