Provider Demographics
NPI:1295317063
Name:WEINSCHREIDER, KIMBERLY (RPH)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:WEINSCHREIDER
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 1:134 TEEL CT
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:VA
Mailing Address - Zip Code:24151-2651
Mailing Address - Country:US
Mailing Address - Phone:540-420-1274
Mailing Address - Fax:
Practice Address - Street 1:5350 CLEARBROOK VILLAGE LN
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24014-6606
Practice Address - Country:US
Practice Address - Phone:540-772-7193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-22
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202207186183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist