Provider Demographics
NPI:1720070287
Name:STANLEY, DENNIS D (RPH)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:D
Last Name:STANLEY
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 1:12087 BIRCHLEAF DR
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23146-1839
Mailing Address - Country:US
Mailing Address - Phone:804-677-8538
Mailing Address - Fax:804-364-1495
Practice Address - Street 1:3460 PUMP RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23233-1111
Practice Address - Country:US
Practice Address - Phone:804-364-1487
Practice Address - Fax:804-364-1495
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202004857183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist