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NPI Code Detail

MEDICARE: ALPHA CARE PHARMACY INC

MEDICARE: ALPHA CARE PHARMACY INC
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
1333600000XPharmacy
2332B00000XDurable Medical Equipment & Medical Supplies
33336C0004XCompounding Pharmacy
43336L0003XLong Term Care Pharmacy
53336S0011XSpecialty Pharmacy
63336C0003XCommunity/Retail PharmacyRX1200009WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1RX2200172OTHERDCPHARMACY PERMIT

General Provider Information

NPI Number : 1548520612
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALPHA CARE PHARMACY INC
Provider Business Mailing Address
First Line : 41010 MISTY VALE CIR
Second Line :
City : ALDIE
State : VA
Zip : 20105-2347
Country : US
Telephone Number : 703-786-8402
Fax Number :
Provider Business Practice Location Address
First Line : 1638 R ST NW STE 1
Second Line :
City : WASHINGTON
State : DC
Zip : 20009-6446
Country : US
Telephone Number : 202-265-7979
Fax Number : 202-265-0589
Authorized Official
Title or Position : AUTHORIZED OFFICIAL
Name : JAN HERMINA
Credential :
Telephone Number : 469-667-3352
Provider Enumeration Date : 05/23/2012
Last Update Date : 12/29/2022

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Directions to “ALPHA CARE PHARMACY INC ” Practice Location

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