MEDICARE: ALYSIA BLAIS

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	1835P2201X	Ambulatory Care Pharmacist	0202223506	VA

General Provider Information

NPI Number	:	1992649651
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALYSIA BLAIS

Provider Business Mailing Address
First Line	:	5764 N OTTAWA RD
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-3917
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1330 SENTARA PARK
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23464-5884
Country	:	US
Telephone Number	:	757-974-0602
Fax Number	:

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

Provider Enumeration Date	:	04/15/2026
Last Update Date	:	04/15/2026

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