Provider Demographics
NPI:1467747972
Name:TOWLER, WILLIAM A
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:A
Last Name:TOWLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4911 GROVE AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-1603
Mailing Address - Country:US
Mailing Address - Phone:804-355-3405
Mailing Address - Fax:804-358-3550
Practice Address - Street 1:4911 GROVE AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-1603
Practice Address - Country:US
Practice Address - Phone:804-355-3405
Practice Address - Fax:804-358-3550
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-13
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202010124183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist