Provider Demographics
NPI:1689173726
Name:GONZALEZ, ANTHONY GOVIN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:GOVIN
Last Name:GONZALEZ
Suffix:
Gender:
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1126 E LYNCHBURG SALEM TPKE
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:VA
Mailing Address - Zip Code:24523-3446
Mailing Address - Country:US
Mailing Address - Phone:540-586-6176
Mailing Address - Fax:
Practice Address - Street 1:1126 E LYNCHBURG SALEM TPKE
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:VA
Practice Address - Zip Code:24523-3446
Practice Address - Country:US
Practice Address - Phone:540-586-6176
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-05
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPH-4221183500000X
VA0202222411183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIPH-4221OtherHI BOARD OF PHARMACY
VA0202222411OtherVA BOARD OF PHARMACY