Provider Demographics
NPI:1295003150
Name:LOPEZ, LAWRENCE ANTONIO (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:ANTONIO
Last Name:LOPEZ
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 1:706 N BELMONT AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23221-1632
Mailing Address - Country:US
Mailing Address - Phone:804-901-7600
Mailing Address - Fax:
Practice Address - Street 1:4201 MEADOWDALE BLVD
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23234-5465
Practice Address - Country:US
Practice Address - Phone:804-271-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-07
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202208818183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist