Upper Mattaponi Indian Tribe

NPI #1447838750 in Aylett, Virginia

Provider Information

NPI Number
1447838750
Entity Type
Organization
Organization Name
Upper Mattaponi Indian Tribe
Primary Specialty
Pharmacy
Enumeration Date
Mar 30, 2021
Last Updated
Nov 17, 2023

Practice Location

Address
7864 RICHMOND TAPPAHANNOCK HWY
City
Aylett
ZIP Code
23009-3056
Phone
(804) 769-2015

Authorized Official

Name
STEVE TUPPONCE
Title
DIRECTOR
Phone
(804) 347-4109

Specialties & Taxonomy Codes

Specialty
Pharmacy

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