Provider Demographics
NPI:1487261038
Name:TUNE, JOHNNY BROOKS JR (PHARMD)
Entity type:Individual
Prefix:MR
First Name:JOHNNY
Middle Name:BROOKS
Last Name:TUNE
Suffix:JR
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2110 ARDEN CREEK WAY
Mailing Address - Street 2:APT 6303
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901
Mailing Address - Country:US
Mailing Address - Phone:903-244-7509
Mailing Address - Fax:
Practice Address - Street 1:130 W. MAIN ST
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:VA
Practice Address - Zip Code:22960
Practice Address - Country:US
Practice Address - Phone:540-661-5006
Practice Address - Fax:540-661-5010
Is Sole Proprietor?:No
Enumeration Date:2020-09-28
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0202218379183500000X
DCPH100002022183500000X
ARPD13297183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist