MEDICARE: SARAH ELIZABETH GREGORY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183700000X	Pharmacy Technician

General Provider Information

NPI Number	:	1124901566
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH ELIZABETH GREGORY

Provider Business Mailing Address
First Line	:	5551 LYNBROOK LNDG
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-1171
Country	:	US
Telephone Number	:	314-435-1239
Fax Number	:

Provider Business Practice Location Address
First Line	:	4500 VIRGINIA BEACH BLVD
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-3004
Country	:	US
Telephone Number	:	757-490-4651
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/30/2025
Last Update Date	:	07/30/2025

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