Provider Demographics
NPI:1881696235
Name:JEROS, URISH (PHARMACIST)
Entity type:Individual
Prefix:MR
First Name:URISH
Middle Name:
Last Name:JEROS
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2975 WILLOW TRACE LN
Mailing Address - Street 2:
Mailing Address - City:SANDY HOOK
Mailing Address - State:VA
Mailing Address - Zip Code:23153-2252
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7127 STAPLES MILL RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23228-4110
Practice Address - Country:US
Practice Address - Phone:804-264-2516
Practice Address - Fax:804-264-9077
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202205645183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist