Provider Demographics
NPI:1194433110
Name:NEWELL, JANICE M (RPH)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:M
Last Name:NEWELL
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 1:1916 ORANGE AVE NW
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24017-4040
Mailing Address - Country:US
Mailing Address - Phone:540-981-1136
Mailing Address - Fax:
Practice Address - Street 1:1916 ORANGE AVE NW
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24017-4040
Practice Address - Country:US
Practice Address - Phone:540-981-1136
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-08
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202011100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist