Healthcare Provider Details

I. General information

NPI: 1922809540
Provider Name (Legal Business Name): FISHING POINT HEALTHCARE PHARMACY #002
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2025
Last Update Date: 03/20/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2315 JEFFERSON AVE
NEWPORT NEWS VA
23607-4509
US

IV. Provider business mailing address

2315 JEFFERSON AVE
NEWPORT NEWS VA
23607-4509
US

V. Phone/Fax

Practice location:
  • Phone: 757-586-5552
  • Fax: 757-586-5558
Mailing address:
  • Phone: 757-586-5552
  • Fax: 757-586-5558

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code332800000X
TaxonomyIndian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. MICHAEL THOMAS PIGFORD II
Title or Position: DIRECTOR OF PHARMACY
Credential: PHARMD
Phone: 757-287-5145