Provider Demographics
NPI:1194008029
Name:QUIGLEY, BRIAN STEPHEN SR (BS, RPH)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:STEPHEN
Last Name:QUIGLEY
Suffix:SR
Gender:M
Credentials:BS, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2044 LYNNHAVEN PKWY
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23456-1409
Mailing Address - Country:US
Mailing Address - Phone:757-471-4998
Mailing Address - Fax:
Practice Address - Street 1:2044 LYNNHAVEN PKWY
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23456-1409
Practice Address - Country:US
Practice Address - Phone:757-471-4998
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-27
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202007722183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist