Provider Demographics
NPI:1740382910
Name:GARBER, JOHNNY WAYNE (RPH)
Entity Type:Individual
Prefix:
First Name:JOHNNY
Middle Name:WAYNE
Last Name:GARBER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 EMERY ST
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-2705
Mailing Address - Country:US
Mailing Address - Phone:540-434-2379
Mailing Address - Fax:540-574-2189
Practice Address - Street 1:305 SOUTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:TIMBERVILLE
Practice Address - State:VA
Practice Address - Zip Code:22853
Practice Address - Country:US
Practice Address - Phone:540-896-3171
Practice Address - Fax:540-896-3145
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202004384183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist