Provider Demographics
NPI:1386775112
Name:BUCHANAN, CHRIS (RPH)
Entity type:Individual
Prefix:
First Name:CHRIS
Middle Name:
Last Name:BUCHANAN
Suffix:
Gender:M
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:PO BOX 538
Mailing Address - Street 2:
Mailing Address - City:KENBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:23944-0538
Mailing Address - Country:US
Mailing Address - Phone:434-676-1393
Mailing Address - Fax:
Practice Address - Street 1:111 S. BROAD ST.
Practice Address - Street 2:
Practice Address - City:KENBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:23944
Practice Address - Country:US
Practice Address - Phone:434-676-2266
Practice Address - Fax:434-676-1052
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202010672183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist