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General NPI Number Information
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NPI Number | 1801488424
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Entity Type | Individual
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Provider Name | JOHN J GIANNOUTSOS PHARMACIST
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Gender | Male
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Dates
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Enumeration Date | 02/04/2021
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Last Update Date | 02/04/2021
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Provider Practice Location Address
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Address Line | 310 S ROSEMONT RD
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452-4224
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Country | US
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Telephone | 757-486-0480
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Fax |
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Provider Business Mailing Address
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Address Line | 1333 DUNSTAN LN
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City | VIRGINIA BEACH
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State | VA
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Zip | 23455-4903
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Country | US
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Telephone | 757-202-0519
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Fax | 757-363-9704
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0202006563
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License Number State | VA
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