Organization
MARTHA JEFFERSON HOSPITAL
Active
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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