MEDICARE: AMERICAN MARITIME HOLDINGS 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	333600000X	Pharmacy
2	3336C0002X	Clinic Pharmacy
3	3336C0003X	Community/Retail Pharmacy	0201004341	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4842301	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number	:	1518286863
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERICAN MARITIME HOLDINGS INC

Provider Business Mailing Address
First Line	:	816 INDUSTRIAL AVE
Second Line	:	SUITE 100
City	:	CHESAPEAKE
State	:	VA
Zip	:	23324-2615
Country	:	US
Telephone Number	:	757-233-9055
Fax Number	:	757-217-0272

Provider Business Practice Location Address
First Line	:	816 INDUSTRIAL AVE
Second Line	:	SUITE 100
City	:	CHESAPEAKE
State	:	VA
Zip	:	23324-2615
Country	:	US
Telephone Number	:	757-233-9055
Fax Number	:	757-217-0272

Authorized Official
Title or Position	:	PHARMACYDIRECTOR
Name	:	MARK MORRELL
Credential	:
Telephone Number	:	757-233-9055

Provider Enumeration Date	:	05/26/2010
Last Update Date	:	05/11/2012

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