Provider Demographics
NPI:1740562354
Name:MARZOA, MARIA (RPH)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:
Last Name:MARZOA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5305 INDIAN RIVER RD
Mailing Address - Street 2:PHARMACY DEPARTMENT
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-5320
Mailing Address - Country:US
Mailing Address - Phone:757-467-0953
Mailing Address - Fax:757-467-2468
Practice Address - Street 1:5305 INDIAN RIVER RD
Practice Address - Street 2:PHARMACY DEPARTMENT
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-5320
Practice Address - Country:US
Practice Address - Phone:757-467-0953
Practice Address - Fax:757-467-2468
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-10
Last Update Date:2011-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202009984183500000X
TX20667183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist