Healthcare Provider Details

I. General information

NPI: 1386456804
Provider Name (Legal Business Name): ANTHONY ENDERBY PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2025
Last Update Date: 01/22/2025
Certification Date: 01/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 MICHIGAN AVE NW EMERGENCY DEPT
WASHINGTON DC
20010
US

IV. Provider business mailing address

111 MICHIGAN AVE NW EMERGENCY DEPT
WASHINGTON DC
20010
US

V. Phone/Fax

Practice location:
  • Phone: 202-476-4084
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835E0208X
TaxonomyEmergency Medicine Pharmacist
License NumberPH100003311
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: