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NPI Code Detail

MEDICARE: PHILOMINA FON PHARMD

MEDICARE: PHILOMINA FON PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseRN1017158DC
2183500000XPharmacist26841MD
3171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1215523063
Entity Type Code : Individual
Provider Name (Legal Business Name) : PHILOMINA FON PHARMD
Provider Business Mailing Address
First Line : 10100 RIDGE ST
Second Line :
City : LANHAM
State : MD
Zip : 20706-4754
Country : US
Telephone Number : 240-604-3569
Fax Number :
Provider Business Practice Location Address
First Line : 2501 GOOD HOPE RD SE
Second Line :
City : WASHINGTON
State : DC
Zip : 20020-3011
Country : US
Telephone Number : 202-866-7505
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/16/2020
Last Update Date : 08/17/2023

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Directions to “ PHILOMINA FON PHARMD” Practice Location

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