Organization
SENTARA LIFE CARE CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIA ACHILLEOS PHARMD (CLINICAL PHARMACY SPECIALIST)
(757) 252-0988
Entity
Organization
Contact information
Practice address
800 INDEPENDENCE BLVD, SUITE 100, VIRGINIA BEACH, VA 23455-6005
(757) 252-0975
(757) 363-6104
Mailing address
800 INDEPENDENCE BLVD, SUITE 100, VIRGINIA BEACH, VA 23455-6005
(757) 252-0975
(757) 363-6104
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
0201003712
VA
3336L0003X
Long Term Care Pharmacy
07702
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008519251
—
VA
05
—
0497061
—
NC
01
—
19199
OPTIMA PROVIDER #
—
01
—
245139
ANTHEM PROVIDER #
—
01
—
4437379
AETNA PROVIDER#
—
01
—
4835813
NABP
—
Enumeration date
10/27/2005
Last updated
03/30/2018
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