Provider Demographics
NPI:1952681736
Name:SEGALL, JANICE W (RPH)
Entity Type:Individual
Prefix:MS
First Name:JANICE
Middle Name:W
Last Name:SEGALL
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 1:12404 WARWICK BLVD
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-3007
Mailing Address - Country:US
Mailing Address - Phone:757-595-3524
Mailing Address - Fax:757-595-3538
Practice Address - Street 1:12404 WARWICK BLVD
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-3007
Practice Address - Country:US
Practice Address - Phone:757-595-3524
Practice Address - Fax:757-595-3538
Is Sole Proprietor?:No
Enumeration Date:2011-08-24
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202005928183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist