Provider Demographics
NPI:1487254900
Name:VANCE, GINGER MARIE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:GINGER
Middle Name:MARIE
Last Name:VANCE
Suffix:
Gender:F
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:PO BOX 8691
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23450-8691
Mailing Address - Country:US
Mailing Address - Phone:304-881-1100
Mailing Address - Fax:
Practice Address - Street 1:1098 FREDERICK BLVD
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23707-4119
Practice Address - Country:US
Practice Address - Phone:757-399-6150
Practice Address - Fax:757-399-6178
Is Sole Proprietor?:No
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202212415183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist