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Contact Information

JERRY M VANBROCKLIN
2263 MAGNOLIA AVE
BUENA VISTA, VA24416
 Phone: 540-261-2896
 Fax: 540-261-1635
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pharmacist

183500000X
Indicates primary specialty

NPI Profile & details for JERRY M VANBROCKLIN · (Male)

NPI Number 1093086381
Status Active
Credentials
Entity Individual
Enumeration date 01/19/2012
Last updated 01/19/2012 - About 14 years ago
Sole proprietor 1 No
Identifiers
  • VA License # 0202010002
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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