Provider Demographics
NPI:1497039077
Name:BETCHAR, ROSENLAL (BPHARM)
Entity Type:Individual
Prefix:
First Name:ROSENLAL
Middle Name:
Last Name:BETCHAR
Suffix:
Gender:M
Credentials:BPHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25421 EASTERN MARKETPLACE PLZ
Mailing Address - Street 2:
Mailing Address - City:CHANTILLY
Mailing Address - State:VA
Mailing Address - Zip Code:20152-5780
Mailing Address - Country:US
Mailing Address - Phone:703-327-7817
Mailing Address - Fax:703-327-2618
Practice Address - Street 1:25421 EASTERN MARKETPLACE PLZ
Practice Address - Street 2:
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20152-5780
Practice Address - Country:US
Practice Address - Phone:703-327-7817
Practice Address - Fax:703-327-2618
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-30
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202012002183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist