Provider Demographics
NPI:1740044890
Name:STANSBURY JR., RICHARD LEE JR (PHARMD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:LEE
Last Name:STANSBURY JR.
Suffix:JR
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 MARTINGALE DR
Mailing Address - Street 2:
Mailing Address - City:TAZEWELL
Mailing Address - State:VA
Mailing Address - Zip Code:24651-7000
Mailing Address - Country:US
Mailing Address - Phone:276-988-4871
Mailing Address - Fax:276-988-6966
Practice Address - Street 1:160 MARTINGALE DR
Practice Address - Street 2:
Practice Address - City:TAZEWELL
Practice Address - State:VA
Practice Address - Zip Code:24651-7000
Practice Address - Country:US
Practice Address - Phone:276-988-4871
Practice Address - Fax:276-988-6966
Is Sole Proprietor?:No
Enumeration Date:2024-02-09
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202012553183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist