Provider Demographics
NPI:1942812615
Name:MORRISON, TAMARA (PHARM D)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:
Last Name:MORRISON
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:BASSETT
Mailing Address - State:VA
Mailing Address - Zip Code:24055-4394
Mailing Address - Country:US
Mailing Address - Phone:276-629-2547
Mailing Address - Fax:276-629-2478
Practice Address - Street 1:400 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:BASSETT
Practice Address - State:VA
Practice Address - Zip Code:24055-4394
Practice Address - Country:US
Practice Address - Phone:276-629-2547
Practice Address - Fax:276-629-2478
Is Sole Proprietor?:No
Enumeration Date:2020-08-23
Last Update Date:2020-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202210720183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0336574Other0336574