Provider Demographics
NPI:1649565540
Name:BODIE, CHERYL RUTH (RPH)
Entity Type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:RUTH
Last Name:BODIE
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 1:7107 FOREST HILL AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23225-1501
Mailing Address - Country:US
Mailing Address - Phone:804-330-3526
Mailing Address - Fax:804-482-7779
Practice Address - Street 1:7107 FOREST HILL AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23225-1501
Practice Address - Country:US
Practice Address - Phone:804-330-3526
Practice Address - Fax:804-482-7779
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-20
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202006993183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist