Provider Demographics
NPI:1427332733
Name:PRINZBACH, DAVID CHRISTOPHER (RPH)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:CHRISTOPHER
Last Name:PRINZBACH
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 1:1215 CHESDIN DR
Mailing Address - Street 2:
Mailing Address - City:FOREST
Mailing Address - State:VA
Mailing Address - Zip Code:24551-4474
Mailing Address - Country:US
Mailing Address - Phone:434-525-1055
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:434-534-0022
Practice Address - Fax:434-534-0023
Is Sole Proprietor?:No
Enumeration Date:2011-10-05
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202011902183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist