Provider Demographics
NPI:1558650093
Name:TARRER, VIRGINIA DELORES
Entity Type:Individual
Prefix:MS
First Name:VIRGINIA
Middle Name:DELORES
Last Name:TARRER
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 1:11315 CARTERS HEIGHTS RD
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:VA
Mailing Address - Zip Code:23005-8036
Mailing Address - Country:US
Mailing Address - Phone:804-752-5844
Mailing Address - Fax:
Practice Address - Street 1:104 W BROADDUS AVE
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:VA
Practice Address - Zip Code:22427-9404
Practice Address - Country:US
Practice Address - Phone:804-633-5058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-05
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202005544183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist