Provider Demographics
NPI:1306438619
Name:DARBY, IRVING EVERETTE III
Entity type:Individual
Prefix:
First Name:IRVING
Middle Name:EVERETTE
Last Name:DARBY
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13502 MIDLOTHIAN TPKE
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-4214
Mailing Address - Country:US
Mailing Address - Phone:804-794-5592
Mailing Address - Fax:804-379-9943
Practice Address - Street 1:13502 MIDLOTHIAN TPKE
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-4214
Practice Address - Country:US
Practice Address - Phone:804-794-5592
Practice Address - Fax:804-379-9943
Is Sole Proprietor?:No
Enumeration Date:2021-02-08
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202005682183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist