Provider Demographics
NPI:1952061434
Name:MASUDA, QUAMRUN (RPH, PHD)
Entity Type:Individual
Prefix:
First Name:QUAMRUN
Middle Name:
Last Name:MASUDA
Suffix:
Gender:F
Credentials:RPH, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1408 SELMA LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23223-1263
Mailing Address - Country:US
Mailing Address - Phone:276-385-0100
Mailing Address - Fax:
Practice Address - Street 1:1408 SELMA LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23223-1263
Practice Address - Country:US
Practice Address - Phone:276-385-0100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-23
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202212597183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty