Provider Demographics
NPI:1295378750
Name:SCHRECENGOST, TRAVIS CHRISTOPHER (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TRAVIS
Middle Name:CHRISTOPHER
Last Name:SCHRECENGOST
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 1:2113 BARTON AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23222-4401
Mailing Address - Country:US
Mailing Address - Phone:540-447-0255
Mailing Address - Fax:
Practice Address - Street 1:2259 LANGHORNE RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501-1114
Practice Address - Country:US
Practice Address - Phone:434-845-5953
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-28
Last Update Date:2020-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202214335183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist