Provider Demographics
NPI:1326339656
Name:FREEMAN, WORTHINGTON H (RPH)
Entity Type:Individual
Prefix:MR
First Name:WORTHINGTON
Middle Name:H
Last Name:FREEMAN
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 1:551 HARBOR VIEW CIR
Mailing Address - Street 2:
Mailing Address - City:OAK GROVE
Mailing Address - State:VA
Mailing Address - Zip Code:22443-5040
Mailing Address - Country:US
Mailing Address - Phone:804-224-0261
Mailing Address - Fax:
Practice Address - Street 1:700 MCKINNEY BLVD
Practice Address - Street 2:
Practice Address - City:COLONIAL BEACH
Practice Address - State:VA
Practice Address - Zip Code:22443-1925
Practice Address - Country:US
Practice Address - Phone:804-224-2318
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-20
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202001278183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist