Healthcare Provider Details

I. General information

NPI: 1366734956
Provider Name (Legal Business Name): MR. DAVID DENNIS PERRY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2011
Last Update Date: 04/28/2025
Certification Date: 04/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2544 BAINBRIDGE BLVD STE B
CHESAPEAKE VA
23324-1859
US

IV. Provider business mailing address

2544 BAINBRIDGE BLVD STE B
CHESAPEAKE VA
23324-1859
US

V. Phone/Fax

Practice location:
  • Phone: 757-312-6790
  • Fax: 757-917-5456
Mailing address:
  • Phone: 573-126-7907
  • Fax: 757-917-5456

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202007036
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number0202007036
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: