Healthcare Provider Details

I. General information

NPI: 1184871261
Provider Name (Legal Business Name): SHRIMAYI JANAK DESAI PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2008
Last Update Date: 07/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6900 GEORGIA AVE NW
WASHINGTON DC
20307-0003
US

IV. Provider business mailing address

WALTER REED NATIONAL MILITARY CTR 8901 WISCONSIN AVENUE
BETHESDA MD
20889-0001
US

V. Phone/Fax

Practice location:
  • Phone: 864-884-5184
  • Fax:
Mailing address:
  • Phone: 864-884-5184
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number0202208144
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: