MEDICARE: MR. DAVID ALBERT MARTELL 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	0202004329	VA

General Provider Information

NPI Number	:	1346548070
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAVID ALBERT MARTELL RPH

Provider Business Mailing Address
First Line	:	5210 OAKLAWN BLVD
Second Line	:
City	:	HOPEWELL
State	:	VA
Zip	:	23860-7336
Country	:	US
Telephone Number	:	804-458-8688
Fax Number	:	804-458-1803

Provider Business Practice Location Address
First Line	:	5210 OAKLAWN BLVD
Second Line	:
City	:	HOPEWELL
State	:	VA
Zip	:	23860-7336
Country	:	US
Telephone Number	:	804-458-8688
Fax Number	:	804-458-1803

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

Provider Enumeration Date	:	03/04/2011
Last Update Date	:	03/04/2011

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