Basic Information
| Provider Information | |||||||||
| NPI: | 1619547254 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MATTHEWS | ||||||||
| FirstName: | SARAH | ||||||||
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| Credential: | CPHT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1357 PINE CONE CIR APT 100 | ||||||||
| Address2: | |||||||||
| City: | VIRGINIA BEACH | ||||||||
| State: | VA | ||||||||
| PostalCode: | 234532735 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 3201 HOLLAND RD | ||||||||
| Address2: | |||||||||
| City: | VIRGINIA BEACH | ||||||||
| State: | VA | ||||||||
| PostalCode: | 234532828 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7578217681 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/27/2021 | ||||||||
| LastUpdateDate: | 06/27/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/27/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183700000X | 0230035548 | VA | Y | Pharmacy Service Providers | Pharmacy Technician |
No ID Information.