Healthcare Provider Details

I. General information

NPI: 1740444231
Provider Name (Legal Business Name): JAMES WATT VERMAAK BPHARM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2008
Last Update Date: 07/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3653 VIRGINIA BEACH BLVD
VIRGINIA BEACH VA
23452-3418
US

IV. Provider business mailing address

2449 BULLOCK TRL
VIRGINIA BEACH VA
23454-5220
US

V. Phone/Fax

Practice location:
  • Phone: 757-463-2011
  • Fax:
Mailing address:
  • Phone: 757-463-5009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202207700
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: