Mack, Tiasara
Mack, Tiasara is an individual health care provider with primary practice located at 1832 Kempsville Rd , Virginia Beach VA 23464-6861. She recently has only one registered license in Pharmacy Service Providers / Geriatric, which is considered as her primary health care specialty. Mack, Tiasara can be contacted via phone (757) 278-2573.Contact Information
Primary practice address
1832 Kempsville Rd
Virginia Beach VA 23464-6861
Phone: (757) 278-2573
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Pharmacy Service Providers / Geriatric | 1835G0303X | 0202215182 | Virginia |
Profile Details
NPI number | 1699377135 |
---|---|
LBN Legal business name | Mack, Tiasara |
Credentials | PHARMD |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Nov 10th, 2020 |
Last updated | Nov 10th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1699377135 | NPPES |
Virginia | Other | 0202215182 | VIRGINIA BOARD OF PHARMACY LICENSE NUMBER |
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