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Organization

MARTHA JEFFERSON HOSPITAL

Active
Other names
Sentara Martha Jefferson Outpatient Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
J. MICHAEL BURRIS RPH (VP, CHIEF FINANCIAL OFFICER)
(434) 654-7305
Entity
Organization

Contact information

Practice address
500 MARTHA JEFFERSON DR, CHARLOTTESVILLE, VA 22911-4668
(434) 654-3348
(434) 654-3353
Mailing address
500 MARTHA JEFFERSON DR, BOX G288, CHARLOTTESVILLE, VA 22911-4668
(434) 654-3348
(434) 654-3353

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
0201004441
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1437420213
VA
01
2133540
PK
Enumeration date
01/25/2012
Last updated
04/19/2016
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