Provider Demographics
NPI:1841505583
Name:SPICER, TIFFANY WHITE (PHARM D)
Entity type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:WHITE
Last Name:SPICER
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 1:105 BRADLEY DR
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24501-4950
Mailing Address - Country:US
Mailing Address - Phone:434-845-5290
Mailing Address - Fax:800-874-9625
Practice Address - Street 1:105 BRADLEY DR
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501-4950
Practice Address - Country:US
Practice Address - Phone:434-845-5290
Practice Address - Fax:800-874-9625
Is Sole Proprietor?:No
Enumeration Date:2010-08-17
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202210155183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist