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NPI Code Detail

MEDICARE: BAYVIEW PLAZA PHARMACY INC

MEDICARE: BAYVIEW PLAZA PHARMACY INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical Supplies0201001900VA
2333600000XPharmacyAB9807009VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10201001900OTHERVABOARD OF PHARMACY
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
44817409OTHERVANCPDP NUMBER

General Provider Information

NPI Number : 1083691836
Entity Type Code : Organization
Provider Name (Legal Business Name) : BAYVIEW PLAZA PHARMACY INC
Provider Business Mailing Address
First Line : 7924 CHESAPEAKE BLVD STE A
Second Line :
City : NORFOLK
State : VA
Zip : 23518-3801
Country : US
Telephone Number : 757-583-7466
Fax Number :
Provider Business Practice Location Address
First Line : 7924 CHESAPEAKE BLVD STE A
Second Line :
City : NORFOLK
State : VA
Zip : 23518-3801
Country : US
Telephone Number : 757-583-7466
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : MR. MICHAEL EUGENE STREDLER
Credential : RPH
Telephone Number : 757-583-7466
Provider Enumeration Date : 12/22/2005
Last Update Date : 03/07/2023

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Directions to “BAYVIEW PLAZA PHARMACY INC ” Practice Location

Language Start Address Practice Location
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