Provider Demographics
NPI:1124321849
Name:SMITH, ANNE SHELBURNE (PHARMD)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:SHELBURNE
Last Name:SMITH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15069 FOREST RD
Mailing Address - Street 2:
Mailing Address - City:FOREST
Mailing Address - State:VA
Mailing Address - Zip Code:24551-3900
Mailing Address - Country:US
Mailing Address - Phone:434-534-0021
Mailing Address - Fax:
Practice Address - Street 1:15069 FOREST RD
Practice Address - Street 2:
Practice Address - City:FOREST
Practice Address - State:VA
Practice Address - Zip Code:24551-3900
Practice Address - Country:US
Practice Address - Phone:434-534-0021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-20
Last Update Date:2012-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202207113183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist