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NPI Code Detail

MEDICARE: SERINA PHILLIP RPH

MEDICARE:   SERINA  PHILLIP  RPH
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
1183500000XPharmacist0203019155VA

General Provider Information

NPI Number : 1215643952
Entity Type Code : Individual
Provider Name (Legal Business Name) : SERINA PHILLIP RPH
Provider Business Mailing Address
First Line : 3631 RADFORD ST
Second Line :
City : NORFOLK
State : VA
Zip : 23513-4029
Country : US
Telephone Number : 757-576-6989
Fax Number :
Provider Business Practice Location Address
First Line : 3600 TIDEWATER DR
Second Line :
City : NORFOLK
State : VA
Zip : 23509-1436
Country : US
Telephone Number : 757-623-2706
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/26/2023
Last Update Date : 01/26/2023

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Directions to “ SERINA PHILLIP RPH” Practice Location

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