NPIMap

Organization Active NPI

Peninsula Health Center Pharmacy

  • Clinic Pharmacy
  • Newport News, VA
National Provider Identifier
1063590073
Registry record updated Dec 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
License
0201000510 Issued in VA
Legal business name
PENINSULA HEALTH CENTER PHARMACY
Practice address
416 J Clyde Morris Blvd
Newport News, VA 23601
Phone
(757) 594-7431
Fax
(757) 594-7199
NPI assigned
Nov 1, 2006
Last updated
Dec 19, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. David Haskell Trump, MD MPHNPI 1982792347
Title
District Health Director
Phone
(757) 594-7305

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X 0201000510 VA Primary

Addresses

Primary practice location

416 J Clyde Morris Blvd
Newport News, VA 23601

Mailing address

416 J Clyde Morris Blvd
Newport News, VA 23601
Phone (757) 594-7431

Other identifiers 2

IdentifierTypeStateIssuer
8507864MedicaidVA
4807383OtherNABP

National Provider Directory

National Provider Directory
Tax ID family
Dickenson Co Health Dep163 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 22

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 22

Locations

416 J Clyde Morris Blvd
Newport News, VA 23601
Phone (750) 594-7305

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198022400000",
    "number": "1063590073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 J CLYDE MORRIS BLVD",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "23601",
            "telephone_number": "757-594-7431",
            "fax_number": "757-594-7199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 J CLYDE MORRIS BLVD",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "23601",
            "telephone_number": "757-594-7431",
            "fax_number": "757-594-7199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENINSULA HEALTH CENTER PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-12-19",
        "status": "A",
        "authorized_official_last_name": "TRUMP",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "HASKELL",
        "authorized_official_title_or_position": "DISTRICT HEALTH DIRECTOR",
        "authorized_official_telephone_number": "757-594-7305",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD MPH"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "VA",
            "license": "0201000510",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8507864",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "4807383",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.