| NPI | 1497610604 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEGHAN DENHAM 340 B Director 757-619-6160 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2025-12-19 |
| Last Update Date | 2026-07-14 |