Provider Demographics
NPI:1275556037
Name:VAUGHAN, CELIA NEFF (PHARMACIST)
Entity Type:Individual
Prefix:MRS
First Name:CELIA
Middle Name:NEFF
Last Name:VAUGHAN
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 GLENDALE ROAD
Mailing Address - Street 2:P. O. BOX 568
Mailing Address - City:GALAX
Mailing Address - State:VA
Mailing Address - Zip Code:24333-0568
Mailing Address - Country:US
Mailing Address - Phone:276-236-6724
Mailing Address - Fax:
Practice Address - Street 1:967 EAST STUART DRIVE
Practice Address - Street 2:GALAX PHARMACY
Practice Address - City:GALAX
Practice Address - State:VA
Practice Address - Zip Code:24333-0000
Practice Address - Country:US
Practice Address - Phone:276-236-1120
Practice Address - Fax:276-236-1123
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2009-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202007228183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0202007228OtherPHARMACIST LICENSE NO