MEDICARE: DR. PETER LOUVANSKY JEAN LOUIS PHARMD

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	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	0202218613	VA

General Provider Information

NPI Number	:	1366798274
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PETER LOUVANSKY JEAN LOUIS PHARMD

Provider Business Mailing Address
First Line	:	960 FOREST LAKE DR
Second Line	:	APT # 304
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23464-3628
Country	:	US
Telephone Number	:	305-807-7342
Fax Number	:

Provider Business Practice Location Address
First Line	:	1401 N MAIN ST
Second Line	:
City	:	SUFFOLK
State	:	VA
Zip	:	23434-4352
Country	:	US
Telephone Number	:	757-539-4834
Fax Number	:	757-539-2076

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

Provider Enumeration Date	:	07/29/2012
Last Update Date	:	06/03/2026

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