Provider Demographics
NPI:1265709406
Name:METCALF, PHILLIP C (RPH)
Entity type:Individual
Prefix:MR
First Name:PHILLIP
Middle Name:C
Last Name:METCALF
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 BUFORD RD
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23235-5202
Mailing Address - Country:US
Mailing Address - Phone:804-320-9752
Mailing Address - Fax:804-320-9756
Practice Address - Street 1:20 BUFORD RD
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-5202
Practice Address - Country:US
Practice Address - Phone:804-320-9752
Practice Address - Fax:804-320-9756
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-16
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202005722183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist