Provider Demographics
NPI:1376264531
Name:NORNG, SOVATHAVY (PHARMD)
Entity Type:Individual
Prefix:
First Name:SOVATHAVY
Middle Name:
Last Name:NORNG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 WOODLAKE DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-1342
Mailing Address - Country:US
Mailing Address - Phone:804-305-4338
Mailing Address - Fax:
Practice Address - Street 1:1980 RIO HILL CTR
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-1144
Practice Address - Country:US
Practice Address - Phone:434-978-1661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-07
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202220699183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist