Provider Demographics
NPI:1518552512
Name:HOWLETT, SAMANTHA ROSE
Entity Type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:ROSE
Last Name:HOWLETT
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:PO BOX 570
Mailing Address - Street 2:
Mailing Address - City:MATHEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23109-0570
Mailing Address - Country:US
Mailing Address - Phone:804-725-2556
Mailing Address - Fax:
Practice Address - Street 1:10858 BUCKLEY HALL RD
Practice Address - Street 2:
Practice Address - City:MATHEWS
Practice Address - State:VA
Practice Address - Zip Code:23109-2310
Practice Address - Country:US
Practice Address - Phone:804-725-2556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-02
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202215999183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist