Provider Demographics
NPI:1922881911
Name:PIERCE, PAULA R (RPH, BCGP)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:R
Last Name:PIERCE
Suffix:
Gender:F
Credentials:RPH, BCGP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6137 STUDLEY RD
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116-4746
Mailing Address - Country:US
Mailing Address - Phone:804-241-1512
Mailing Address - Fax:
Practice Address - Street 1:8575 MAGELLAN PKWY
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23227-1164
Practice Address - Country:US
Practice Address - Phone:804-750-6094
Practice Address - Fax:401-369-8029
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-15
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202012492183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist