Theresa Trader, PHARMD
Individual provider Active NPI Pharmacist · Boyce, VA
NPI 1922588441 · NPPES record last updated Feb 23, 2024
Key facts
- NPI
- 1922588441
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 0202217072 (VA)
- Practice address
- 1004 Pyletown Rd
Boyce, VA 22620-1817 - Phone
- (540) 550-3133
- NPI assigned
- Aug 14, 2018
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0202217072 | VA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0202217072 | VA | Yes |
Addresses
Primary practice location
1004 Pyletown Rd
Boyce, VA 22620-1817
Mailing address
1004 Pyletown Rd
Boyce, VA 22620-1817
Phone (540) 550-3133
Other providers in Boyce, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 23, 2024. 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.