Healthcare Provider Details

I. General information

NPI: 1376292334
Provider Name (Legal Business Name): KEMPSVILLE BEHAVIORAL HEALTH PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2022
Last Update Date: 04/11/2022
Certification Date: 04/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

860 KEMPSVILLE RD
NORFOLK VA
23502
US

IV. Provider business mailing address

860 KEMPSVILLE RD
NORFOLK VA
23502
US

V. Phone/Fax

Practice location:
  • Phone: 757-455-0325
  • Fax: 757-455-0301
Mailing address:
  • Phone: 757-455-0325
  • Fax: 757-455-0301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0200X
TaxonomyPediatric Pharmacist
License Number
License Number State

VIII. Authorized Official

Name: STEVE FILTON
Title or Position: SR VP CFO
Credential:
Phone: 610-382-3319