Judith Doretea Ackermann, RPH

Individual provider Active NPI Pharmacist · Virginia Beach, VA

NPI 1114247756 · NPPES record last updated Jun 6, 2010

Key facts

NPI
1114247756
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
0202209188 (VA)
Practice address
1075 Independence Blvd
Virginia Beach, VA 23455-5523
Phone
(757) 464-2565
NPI assigned
Jun 6, 2010
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
0202209188VAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Eckerd Corporation Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0202209188 VA Yes

Addresses

Primary practice location

1075 Independence Blvd
Virginia Beach, VA 23455-5523

Mailing address

1075 Independence Blvd
Virginia Beach, VA 23455-5523
Phone (757) 464-2565

Other providers in Virginia Beach, VA

All providers in Virginia Beach, VA · Pharmacist in Virginia

Sources for this page

Verify at the official NPI Registry.