Provider Demographics
NPI:1295338580
Name:SOROCHIN, CRAIG (RPH)
Entity type:Individual
Prefix:MR
First Name:CRAIG
Middle Name:
Last Name:SOROCHIN
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 1:44 WHITE CEDAR RD
Mailing Address - Street 2:
Mailing Address - City:BARBOURSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22923-2752
Mailing Address - Country:US
Mailing Address - Phone:434-953-3565
Mailing Address - Fax:
Practice Address - Street 1:312 CONNOR DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-5605
Practice Address - Country:US
Practice Address - Phone:434-964-0397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-18
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202204959183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist