Provider Demographics
NPI:1265097331
Name:VOLLES, STACY (PHARMACIST)
Entity type:Individual
Prefix:
First Name:STACY
Middle Name:
Last Name:VOLLES
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 BRANDON AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-3310
Mailing Address - Country:US
Mailing Address - Phone:434-924-1544
Mailing Address - Fax:434-982-0182
Practice Address - Street 1:400 BRANDON AVE
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903-3310
Practice Address - Country:US
Practice Address - Phone:434-924-1544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-04
Last Update Date:2019-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202010739183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist