Healthcare Provider Details

I. General information

NPI: 1437831260
Provider Name (Legal Business Name): CHESAPEAKE HOSPITAL AUTHORITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2023
Last Update Date: 08/02/2023
Certification Date: 08/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

534A CARATOKE HWY
MOYOCK NC
27958-8740
US

IV. Provider business mailing address

736 BATTLEFIELD BLVD N
CHESAPEAKE VA
23320-4941
US

V. Phone/Fax

Practice location:
  • Phone: 757-312-6168
  • Fax:
Mailing address:
  • Phone: 757-312-6482
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: TIMOTHY PAUL GARRETT
Title or Position: DIRECTOR OF PAYOR CONTRACTING
Credential:
Phone: 757-312-6482