Provider Demographics
NPI:1396025516
Name:CALDAS, LAUREN MARSTON
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:MARSTON
Last Name:CALDAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 SWANNEE LN
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:VA
Mailing Address - Zip Code:23005-2197
Mailing Address - Country:US
Mailing Address - Phone:804-572-8600
Mailing Address - Fax:
Practice Address - Street 1:11900 W BROAD ST
Practice Address - Street 2:KROGER PHARMACY
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23233-1007
Practice Address - Country:US
Practice Address - Phone:804-360-3268
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-18
Last Update Date:2011-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA202210666183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist