Provider Demographics
NPI:1447306337
Name:SQUIBB, DEBORAH WARD (RPH)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:WARD
Last Name:SQUIBB
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 25TH ST
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451-4042
Mailing Address - Country:US
Mailing Address - Phone:757-428-8344
Mailing Address - Fax:
Practice Address - Street 1:800 INDEPENDENCE BLVD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-6005
Practice Address - Country:US
Practice Address - Phone:757-363-6174
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202006533183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist