Provider Demographics
NPI:1831218437
Name:ROUSE, ALLISON GRAY (PHARM D)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:GRAY
Last Name:ROUSE
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 1:9613 LOCKBERRY RIDGE LOOP
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23237-3192
Mailing Address - Country:US
Mailing Address - Phone:804-271-3453
Mailing Address - Fax:
Practice Address - Street 1:5201 CHIPPENHAM CROSSING CTR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23234-6901
Practice Address - Country:US
Practice Address - Phone:804-714-0689
Practice Address - Fax:804-714-0712
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202206640183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist