Provider Demographics
NPI:1114527199
Name:MARCHESE RUGGIERO, DAWNE MARIE (RPH)
Entity Type:Individual
Prefix:
First Name:DAWNE
Middle Name:MARIE
Last Name:MARCHESE RUGGIERO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 WALMART WAY
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-2600
Mailing Address - Country:US
Mailing Address - Phone:804-897-0974
Mailing Address - Fax:
Practice Address - Street 1:901 WALMART WAY
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-2600
Practice Address - Country:US
Practice Address - Phone:804-897-0974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-28
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202012552183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist