Provider Demographics
NPI:1063923100
Name:MURPHY, HAZEL THOMAS (RPH)
Entity type:Individual
Prefix:
First Name:HAZEL
Middle Name:THOMAS
Last Name:MURPHY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17924 JAMES RIVER DR
Mailing Address - Street 2:
Mailing Address - City:DISPUTANTA
Mailing Address - State:VA
Mailing Address - Zip Code:23842-9000
Mailing Address - Country:US
Mailing Address - Phone:804-586-6595
Mailing Address - Fax:
Practice Address - Street 1:3201 BOULEVARD
Practice Address - Street 2:
Practice Address - City:COLONIAL HEIGHTS
Practice Address - State:VA
Practice Address - Zip Code:23834-1455
Practice Address - Country:US
Practice Address - Phone:804-524-0003
Practice Address - Fax:804-524-0008
Is Sole Proprietor?:No
Enumeration Date:2017-10-16
Last Update Date:2017-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202011824183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist