NPI 1093353047

Virginia Leo Black, RPH

Practitioner Pharmacist Vicksburg, MS

Practice location

Address: 6010 Castle Rd, Vicksburg, MS 39180-9310
Phone: (601) 636-1718

Registered specialties

Pharmacist Primary

Pharmacy Service Providers Taxonomy 183500000X Licence E-05403 (MS)

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Registry record

NPI: 1093353047
Entity type: Individual
Sex (as registered): Female
NPI issued: 19 Dec 2019
Record last updated: 19 Dec 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.