MEDICARE: D & S PHARMACY INC

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	0201002700	VA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0619800001	OTHER		MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	4824151	OTHER		ALL OTHER INSURANCE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417040197
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	D & S PHARMACY INC

Provider Business Mailing Address
First Line	:	4712 HAMPTON BLVD
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23508
Country	:	US
Telephone Number	:	757-489-4848
Fax Number	:	757-489-9227

Provider Business Practice Location Address
First Line	:	4712 HAMPTON BLVD
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23508-1822
Country	:	US
Telephone Number	:	757-489-4848
Fax Number	:	757-489-9227

Authorized Official
Title or Position	:	PRESIDENT/ PHARMACIST IN CHARGE
Name	:	MR. DAVID J HALLA
Credential	:	RPH
Telephone Number	:	757-489-4848

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	05/09/2011

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Directions to “D & S PHARMACY INC ” Practice Location

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