MEDICARE: LARHONDA HARDY

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	183700000X	Pharmacy Technician	0230023483	VA

General Provider Information

NPI Number	:	1912638230
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LARHONDA HARDY

Provider Business Mailing Address
First Line	:	5521 BROOK ROAD
Second Line	:
City	:	HENRICO
State	:	VA
Zip	:	23227
Country	:	US
Telephone Number	:	804-266-7120
Fax Number	:	804-266-7019

Provider Business Practice Location Address
First Line	:	5521 BROOK ROAD
Second Line	:
City	:	HENRICO
State	:	VA
Zip	:	23227
Country	:	US
Telephone Number	:	804-266-7120
Fax Number	:	804-266-7019

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

Provider Enumeration Date	:	06/17/2022
Last Update Date	:	06/17/2022

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