Provider Demographics
NPI:1669785895
Name:CROPPER, LANNIE WILLIAM JR (RPH)
Entity type:Individual
Prefix:MR
First Name:LANNIE
Middle Name:WILLIAM
Last Name:CROPPER
Suffix:JR
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 1:4408 W HUNDRED RD
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23831-1738
Mailing Address - Country:US
Mailing Address - Phone:804-768-1579
Mailing Address - Fax:804-768-1685
Practice Address - Street 1:4408 W HUNDRED RD
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831-1738
Practice Address - Country:US
Practice Address - Phone:804-768-1579
Practice Address - Fax:804-768-1685
Is Sole Proprietor?:No
Enumeration Date:2010-07-16
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202007463183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist