Provider Demographics
NPI:1003201047
Name:NORRIS, JOHNATHAN (PHARM D)
Entity Type:Individual
Prefix:
First Name:JOHNATHAN
Middle Name:
Last Name:NORRIS
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20230 AVONDALE RD
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24211-6942
Mailing Address - Country:US
Mailing Address - Phone:276-628-9906
Mailing Address - Fax:
Practice Address - Street 1:731 HIGHWAY 11 W
Practice Address - Street 2:
Practice Address - City:CHURCH HILL
Practice Address - State:TN
Practice Address - Zip Code:37642-3146
Practice Address - Country:US
Practice Address - Phone:423-357-0493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-06
Last Update Date:2015-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN33680183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist