Provider Demographics
NPI:1104312156
Name:HEATH, CASSIE LYNN (PHARMD)
Entity type:Individual
Prefix:
First Name:CASSIE
Middle Name:LYNN
Last Name:HEATH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2235 LANDOVER PL STE A
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24501-2193
Mailing Address - Country:US
Mailing Address - Phone:434-338-7764
Mailing Address - Fax:434-338-6810
Practice Address - Street 1:161 BUSH RIVER DR STE 2A
Practice Address - Street 2:
Practice Address - City:FARMVILLE
Practice Address - State:VA
Practice Address - Zip Code:23901-3183
Practice Address - Country:US
Practice Address - Phone:434-607-4135
Practice Address - Fax:434-422-5698
Is Sole Proprietor?:No
Enumeration Date:2018-07-02
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202216520183500000X, 1835P1300X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1300XPharmacy Service ProvidersPharmacistPsychiatric
No183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist