Durotolu Haley
Individual provider Active NPI Pharmacist · Timberville, VA
NPI 1003229972 · NPPES record last updated Jun 8, 2014
Key facts
- NPI
- 1003229972
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 0202207686 (VA)
- Practice address
- 14111 Timber Way
Timberville, VA 22853-9582 - Phone
- (540) 896-6407
- NPI assigned
- Jun 8, 2014
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0202207686 | VA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0202207686 | VA | Yes |
Addresses
Primary practice location
14111 Timber Way
Timberville, VA 22853-9582
Mailing address
14111 Timber Way
Timberville, VA 22853-9582
Phone (540) 896-6407
Other providers in Timberville, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 8, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.