MEDICARE: MR. SCOTT ALAN MAHRENHOLZ 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
1	183500000X	Pharmacist	5052	VA

General Provider Information

NPI Number	:	1245553510
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SCOTT ALAN MAHRENHOLZ RPH

Provider Business Mailing Address
First Line	:	550 FIRST COLONIAL RD
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23451-6186
Country	:	US
Telephone Number	:	757-425-5958
Fax Number	:	757-437-2909

Provider Business Practice Location Address
First Line	:	550 FIRST COLONIAL RD
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23451-6186
Country	:	US
Telephone Number	:	757-425-5958
Fax Number	:	757-437-2909

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/01/2010
Last Update Date	:	03/01/2010

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