Healthcare Provider Details

I. General information

NPI: 1366798274
Provider Name (Legal Business Name): PETER LOUVANSKY JEAN LOUIS PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2012
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 N MAIN ST
SUFFOLK VA
23434-4352
US

IV. Provider business mailing address

960 FOREST LAKE DR APT # 304
VIRGINIA BEACH VA
23464-3628
US

V. Phone/Fax

Practice location:
  • Phone: 757-539-4834
  • Fax: 757-539-2076
Mailing address:
  • Phone: 305-807-7342
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number0202218613
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: