Provider Demographics
NPI:1578779070
Name:SPRUELL, PERRI A (RPH)
Entity Type:Individual
Prefix:
First Name:PERRI
Middle Name:A
Last Name:SPRUELL
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 1:3331 GLADE CREEK BLVD NE
Mailing Address - Street 2:APT. 1
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24012-8625
Mailing Address - Country:US
Mailing Address - Phone:757-581-2926
Mailing Address - Fax:
Practice Address - Street 1:2013 JEFFERSON ST SW
Practice Address - Street 2:2ND FLOOR
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24014-2419
Practice Address - Country:US
Practice Address - Phone:540-982-0237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA02020112981835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology