Provider Demographics
NPI:1033600135
Name:VAN TASSELL, BENJAMIN (PHARMD)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:
Last Name:VAN TASSELL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 980533
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23298-0533
Mailing Address - Country:US
Mailing Address - Phone:804-828-4583
Mailing Address - Fax:
Practice Address - Street 1:410 NORTH 12TH STREET, ROOM 660A
Practice Address - Street 2:VCU SCHOOL OF PHARMACY, BOX 980533
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-0533
Practice Address - Country:US
Practice Address - Phone:804-828-4583
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA02022086281835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy