Victoria Tyler
Individual provider Active NPI Pharmacist · Clarksville, VA
NPI 1083217814 · NPPES record last updated Nov 16, 2020
Key facts
- NPI
- 1083217814
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 0202011541 (VA)
- Practice address
- 24 Gateway LN
Clarksville, VA 23927-3029 - Phone
- (434) 374-8728
- NPI assigned
- Nov 16, 2020
- 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 |
|---|---|---|---|
| 0202011541 | VA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0202011541 | VA | Yes |
Addresses
Primary practice location
24 Gateway LN
Clarksville, VA 23927-3029
Mailing address
2011 E Hitesburg Rd
Virgilina, VA 24598-3317
Phone (434) 572-7848
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | Interstore | ||
| Other URL | Interstore | ||
| Other URL | Interstore | ||
| CONNECT URL | CVS |
Other providers in Clarksville, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 16, 2020. 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.