Healthcare Provider Details

I. General information

NPI: 1952362089
Provider Name (Legal Business Name): AMY MIZE RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: X

Provider Other Name: AMY SAUNDERS SMITH

II. Dates (important events)

Enumeration Date: 03/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 TOMCAT BLVD VIRGINIA BEACH
VIRGINIA BEACH VA
23460-2218
US

IV. Provider business mailing address

417 PLEASANT POINT DR NORFOLK
NORFOLK VA
23502-5703
US

V. Phone/Fax

Practice location:
  • Phone: 757-314-7015
  • Fax:
Mailing address:
  • Phone: 757-461-1362
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: