Healthcare Provider Details

I. General information

NPI: 1174834550
Provider Name (Legal Business Name): HANY R TOMA RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2010
Last Update Date: 06/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13271 WARWICK BLVD
NEWPORT NEWS VA
23602-6721
US

IV. Provider business mailing address

13271 WARWICK BLVD
NEWPORT NEWS VA
23602-6721
US

V. Phone/Fax

Practice location:
  • Phone: 757-874-3047
  • Fax: 757-874-6067
Mailing address:
  • Phone: 757-874-3047
  • Fax: 757-874-6067

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202207316
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: