Mazsure, Lori Vaughan
Mazsure, Lori Vaughan is an individual health care provider with primary practice located at 26317 West Washington Street , Petersburg VA 23803. She recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as her primary health care specialty. Mazsure, Lori Vaughan can be contacted via phone (804) 524-7744.Contact Information
Primary practice address
26317 West Washington Street
Petersburg VA 23803
Phone: (804) 524-7744
Fax: (804) 524-4718
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Pharmacy Service Providers / Pharmacist | 183500000X | 0202205834 | Virginia |
Profile Details
| NPI number | 1467430751 |
|---|---|
| LBN Legal business name | Mazsure, Lori Vaughan |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 6th, 2006 |
| Last updated | Dec 6th, 2011 - about 13 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 | 1467430751 | NPPES |
| Virginia | MEDICAID | 49-0104 |
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