Provider Demographics
NPI:1801676895
Name:LUTZ, WILLIAM (PHARMD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:LUTZ
Suffix:
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 1:100 CHESTERS WAY
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:VA
Mailing Address - Zip Code:22812-1676
Mailing Address - Country:US
Mailing Address - Phone:717-658-9804
Mailing Address - Fax:
Practice Address - Street 1:1151 PORT REPUBLIC RD
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-3509
Practice Address - Country:US
Practice Address - Phone:540-433-2437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-05
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202221573183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist