Provider Demographics
NPI:1609178367
Name:KNOTT, LORETTA M (RPH)
Entity Type:Individual
Prefix:MRS
First Name:LORETTA
Middle Name:M
Last Name:KNOTT
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 1:6335 MECHANICSVILLE TPKE
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23111-4568
Mailing Address - Country:US
Mailing Address - Phone:804-730-6833
Mailing Address - Fax:804-730-4175
Practice Address - Street 1:6335 MECHANICSVILLE TPKE
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23111-4568
Practice Address - Country:US
Practice Address - Phone:804-730-6833
Practice Address - Fax:804-730-4175
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-30
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA02020004841183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist