MEDICARE: ALBERT SHOMADE 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
1	163W00000X	Registered Nurse	RN64761	DC
2	163W00000X	Registered Nurse	R132831	MD
3	183500000X	Pharmacist	PH100000654	DC
4	183500000X	Pharmacist	19065	MD

General Provider Information

NPI Number	:	1710223425
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALBERT SHOMADE PHARMD

Provider Business Mailing Address
First Line	:	7304 CARROLL AVE
Second Line	:	#105
City	:	TAKOMA PARK
State	:	MD
Zip	:	20912-4514
Country	:	US
Telephone Number	:	301-477-3333
Fax Number	:

Provider Business Practice Location Address
First Line	:	1325 14TH ST NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20005-3610
Country	:	US
Telephone Number	:	202-332-8811
Fax Number	:	202-332-3880

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/27/2012
Last Update Date	:	12/27/2012

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Directions to “ ALBERT SHOMADE PHARMD” Practice Location

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