Provider Demographics
NPI:1497035265
Name:DERRER, DENISE L (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:L
Last Name:DERRER
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 1:1790 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-5114
Mailing Address - Country:US
Mailing Address - Phone:540-432-1131
Mailing Address - Fax:540-432-1830
Practice Address - Street 1:1790 E MARKET ST
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-5114
Practice Address - Country:US
Practice Address - Phone:540-432-1131
Practice Address - Fax:540-432-1830
Is Sole Proprietor?:No
Enumeration Date:2011-08-24
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202208623183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist