MEDICARE: HORMONE HEALTH AND WEIGHT LOSS

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
1	261QH0100X	Health Service Clinic/Center		VA

General Provider Information

NPI Number	:	1225466527
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HORMONE HEALTH AND WEIGHT LOSS

Provider Business Mailing Address
First Line	:	502 VIKING DR
Second Line	:	SUITE 200
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23452-7316
Country	:	US
Telephone Number	:	757-213-3333
Fax Number	:	757-213-0213

Provider Business Practice Location Address
First Line	:	502 VIKING DR
Second Line	:	SUITE 200
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23452-7316
Country	:	US
Telephone Number	:	757-213-3333
Fax Number	:	757-213-0213

Authorized Official
Title or Position	:	OFFICE/PATIENT COORDINATOR
Name	:	MELANIE CALHOUN
Credential	:
Telephone Number	:	757-213-3333

Provider Enumeration Date	:	10/23/2013
Last Update Date	:	10/23/2013

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Directions to “HORMONE HEALTH AND WEIGHT LOSS ” Practice Location

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