Provider Demographics
NPI:1679165690
Name:CARRINGTON, GUY EDWARD
Entity type:Individual
Prefix:
First Name:GUY
Middle Name:EDWARD
Last Name:CARRINGTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 DAVID BRUCE AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE COURT HOUSE
Mailing Address - State:VA
Mailing Address - Zip Code:23923-3741
Mailing Address - Country:US
Mailing Address - Phone:434-542-5171
Mailing Address - Fax:
Practice Address - Street 1:120 DAVID BRUCE AVE
Practice Address - Street 2:
Practice Address - City:CHARLOTTE COURT HOUSE
Practice Address - State:VA
Practice Address - Zip Code:23923-3741
Practice Address - Country:US
Practice Address - Phone:434-542-5171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-10
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA02020063541835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0202006354OtherVIRGINIA STATE LICENSE