Provider Demographics
NPI:1821847997
Name:BUSH, PAIGE (PHARM D)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:
Last Name:BUSH
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:471 BRICK CHURCH CIR
Mailing Address - Street 2:
Mailing Address - City:CASTLEWOOD
Mailing Address - State:VA
Mailing Address - Zip Code:24224-5877
Mailing Address - Country:US
Mailing Address - Phone:276-971-5680
Mailing Address - Fax:
Practice Address - Street 1:33472 LEE HWY
Practice Address - Street 2:
Practice Address - City:GLADE SPRING
Practice Address - State:VA
Practice Address - Zip Code:24340-5100
Practice Address - Country:US
Practice Address - Phone:276-429-2004
Practice Address - Fax:276-429-2009
Is Sole Proprietor?:No
Enumeration Date:2024-05-13
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202206649183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist