Provider Demographics
NPI:1366889446
Name:NEGRELLI, VINCENT J (PHARMD)
Entity type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:J
Last Name:NEGRELLI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3676 S 2245 E
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84109-2966
Mailing Address - Country:US
Mailing Address - Phone:919-633-7710
Mailing Address - Fax:
Practice Address - Street 1:2305 OAKLAWN BLVD
Practice Address - Street 2:
Practice Address - City:HOPEWELL
Practice Address - State:VA
Practice Address - Zip Code:23860-5032
Practice Address - Country:US
Practice Address - Phone:804-458-1231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-29
Last Update Date:2014-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9057891183500000X
VA0202211453183500000X
NC22663183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0202211453OtherBOARD OF PHARMACY
UT9057891OtherPHARMACY
NC22663OtherBOARD OF PHARMACY