Provider Demographics
NPI:1780284018
Name:BOJO, CHONA
Entity type:Individual
Prefix:
First Name:CHONA
Middle Name:
Last Name:BOJO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 BUTTERMILK CT
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23456-6934
Mailing Address - Country:US
Mailing Address - Phone:757-647-5825
Mailing Address - Fax:757-563-2736
Practice Address - Street 1:1149 NIMMO PKWY
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23456-7730
Practice Address - Country:US
Practice Address - Phone:757-563-2908
Practice Address - Fax:757-563-2736
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202208110183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist