Provider Demographics
NPI:1144676909
Name:PROPRIUM LLC
Entity type:Organization
Organization Name:PROPRIUM LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:R
Authorized Official - Last Name:HUFFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-553-3111
Mailing Address - Street 1:535 INDEPENDENCE PKWY
Mailing Address - Street 2:SUITE 400
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-5176
Mailing Address - Country:US
Mailing Address - Phone:757-553-3568
Mailing Address - Fax:757-819-7827
Practice Address - Street 1:535 INDEPENDENCE PKWY
Practice Address - Street 2:SUITE 400
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-5176
Practice Address - Country:US
Practice Address - Phone:757-553-3568
Practice Address - Fax:757-819-7827
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SENTARA HOSPITALS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-05-11
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0201004711OtherPHARMACY