Provider Demographics
NPI:1407139363
Name:SAPONE, DEREK ANTHONY (RPH)
Entity Type:Individual
Prefix:MR
First Name:DEREK
Middle Name:ANTHONY
Last Name:SAPONE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:853 ARTESIA WAY
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23456-6725
Mailing Address - Country:US
Mailing Address - Phone:757-301-7442
Mailing Address - Fax:
Practice Address - Street 1:853 ARTESIA WAY
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23456-6725
Practice Address - Country:US
Practice Address - Phone:757-301-7442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-27
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202012911183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist