Provider Demographics
NPI:1942914619
Name:SHAKROO, RUND JAMIL (BPS)
Entity Type:Individual
Prefix:MRS
First Name:RUND
Middle Name:JAMIL
Last Name:SHAKROO
Suffix:
Gender:F
Credentials:BPS
Other - Prefix:MRS
Other - First Name:RUND
Other - Middle Name:ABDULLA
Other - Last Name:JAMIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BPS
Mailing Address - Street 1:10713 CLIFFMORE DRIVE
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060-6451
Mailing Address - Country:US
Mailing Address - Phone:804-617-1872
Mailing Address - Fax:
Practice Address - Street 1:9645 WEST BROAD STREET PUBLIX PHARMACY AT
Practice Address - Street 2:
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23060-4116
Practice Address - Country:US
Practice Address - Phone:804-799-6041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202214598183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist