Provider Demographics
NPI:1689278723
Name:ESCOBAR, JULIET (RPH)
Entity Type:Individual
Prefix:
First Name:JULIET
Middle Name:
Last Name:ESCOBAR
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 1:11804 WESTCOTT LANDING CT
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23059-7077
Mailing Address - Country:US
Mailing Address - Phone:908-399-1297
Mailing Address - Fax:
Practice Address - Street 1:7023 THREE CHOPT RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-3606
Practice Address - Country:US
Practice Address - Phone:804-285-4449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202206802183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist