Provider Demographics
NPI:1710752134
Name:QUINTA, ACHEA
Entity Type:Individual
Prefix:
First Name:ACHEA
Middle Name:
Last Name:QUINTA
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 1:18 JACKMIA WAY
Mailing Address - Street 2:
Mailing Address - City:STAUNTON
Mailing Address - State:VA
Mailing Address - Zip Code:24401-5806
Mailing Address - Country:US
Mailing Address - Phone:770-873-5515
Mailing Address - Fax:
Practice Address - Street 1:599 MOUNT CLINTON PIKE
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22802-2500
Practice Address - Country:US
Practice Address - Phone:540-434-4760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-15
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202221702183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist