Provider Demographics
NPI:1790802767
Name:GOODMAN, KIMBERLY PARRISH (RPH)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:PARRISH
Last Name:GOODMAN
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 1:5181 KEITTS CORNER RD
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23111-6471
Mailing Address - Country:US
Mailing Address - Phone:804-730-5601
Mailing Address - Fax:
Practice Address - Street 1:7324 BELL CREEK RD
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23111-3545
Practice Address - Country:US
Practice Address - Phone:804-746-8131
Practice Address - Fax:804-730-7495
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202010100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist