MEDICARE: PRECIOSA HOFFMANN

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
1	183500000X	Pharmacist	RP0008039	WV
2	183500000X	Pharmacist	0202211777	VA

General Provider Information

NPI Number	:	1497091029
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PRECIOSA HOFFMANN

Provider Business Mailing Address
First Line	:	4001 PRINCE WILLIAM PKWY STE 101
Second Line	:
City	:	WOODBRIDGE
State	:	VA
Zip	:	22192-7667
Country	:	US
Telephone Number	:	804-801-6922
Fax Number	:

Provider Business Practice Location Address
First Line	:	4001 PRINCE WILLIAM PKWY STE 101
Second Line	:
City	:	WOODBRIDGE
State	:	VA
Zip	:	22192-7667
Country	:	US
Telephone Number	:	703-792-7300
Fax Number	:	703-792-7311

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/01/2013
Last Update Date	:	11/01/2023

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