1144221680 NPI number — DR. LORETTA DOROTHY LOMBARDO PHARM.D., R.PH.

Table of content: DR. LORETTA DOROTHY LOMBARDO PHARM.D., R.PH. (NPI 1144221680)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144221680 NPI number — DR. LORETTA DOROTHY LOMBARDO PHARM.D., R.PH.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LOMBARDO
Provider First Name:
LORETTA
Provider Middle Name:
DOROTHY
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHARM.D., R.PH.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1144221680
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
13503 APPLE BARREL CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HERNDON
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
20171-4006
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-777-3389
Provider Business Mailing Address Fax Number:
703-777-4490

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
750 MILLER DR SE
Provider Second Line Business Practice Location Address:
SUITE F-1
Provider Business Practice Location Address City Name:
LEESBURG
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
20175-8916
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-777-3389
Provider Business Practice Location Address Fax Number:
703-777-4490
Provider Enumeration Date:
08/09/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  0202007675 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com