Provider Demographics
NPI:1508155086
Name:LOVING, DEBRA JO (RPH)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:JO
Last Name:LOVING
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17801 SANDS RD
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:VA
Mailing Address - Zip Code:20158-3439
Mailing Address - Country:US
Mailing Address - Phone:540-338-5696
Mailing Address - Fax:
Practice Address - Street 1:609 E MAIN ST
Practice Address - Street 2:
Practice Address - City:PURCELLVILLE
Practice Address - State:VA
Practice Address - Zip Code:20132-4500
Practice Address - Country:US
Practice Address - Phone:540-338-4195
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-05
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202010846183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist