Provider Demographics
NPI:1447378153
Name:HILDEBRAND, MARY JANE (RPH)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:JANE
Last Name:HILDEBRAND
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 1:341 OHIO AVE
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-1834
Mailing Address - Country:US
Mailing Address - Phone:540-209-0183
Mailing Address - Fax:
Practice Address - Street 1:1942 PORT REPUBLIC RD
Practice Address - Street 2:
Practice Address - City:ROCKINGHAM
Practice Address - State:VA
Practice Address - Zip Code:22801-3532
Practice Address - Country:US
Practice Address - Phone:540-282-6950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202208139183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist