Provider Demographics
NPI:1194766519
Name:TODMAN, TARIE GRESHAM (PHARMD)
Entity type:Individual
Prefix:DR
First Name:TARIE
Middle Name:GRESHAM
Last Name:TODMAN
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 1:7900 SCULLY CT
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20111-8268
Mailing Address - Country:US
Mailing Address - Phone:703-330-8878
Mailing Address - Fax:703-330-8878
Practice Address - Street 1:7900 SCULLY CT
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20111
Practice Address - Country:US
Practice Address - Phone:703-531-7852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202206901183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist