Provider Demographics
NPI:1760765358
Name:LOPS, MARIE VIVIANE (RPH)
Entity Type:Individual
Prefix:MS
First Name:MARIE
Middle Name:VIVIANE
Last Name:LOPS
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 1:3965 HOLLAND RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-2804
Mailing Address - Country:US
Mailing Address - Phone:757-306-9255
Mailing Address - Fax:757-306-9244
Practice Address - Street 1:3965 HOLLAND RD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-2804
Practice Address - Country:US
Practice Address - Phone:757-306-9255
Practice Address - Fax:757-306-9244
Is Sole Proprietor?:No
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202011639183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist