Provider Demographics
NPI:1952621401
Name:THARP, LEWIS HULON
Entity Type:Individual
Prefix:MR
First Name:LEWIS
Middle Name:HULON
Last Name:THARP
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7912 HALPRIN DR
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23518-3006
Mailing Address - Country:US
Mailing Address - Phone:757-588-2007
Mailing Address - Fax:757-531-1461
Practice Address - Street 1:7912 HALPRIN DR
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23518-3006
Practice Address - Country:US
Practice Address - Phone:757-588-2007
Practice Address - Fax:757-531-1461
Is Sole Proprietor?:No
Enumeration Date:2010-06-07
Last Update Date:2010-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202005014183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist