Healthcare Provider Details

I. General information

NPI: 1932438181
Provider Name (Legal Business Name): UNITED COMMUNITY PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2009
Last Update Date: 12/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4515 14TH ST NW
WASHINGTON DC
20011-4358
US

IV. Provider business mailing address

13208 BELLEVUE ST
SILVER SPRING MD
20904-1703
US

V. Phone/Fax

Practice location:
  • Phone: 240-460-7060
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberPH3215
License Number StateDC

VIII. Authorized Official

Name: DR. BISRAT HAILEMESKEL
Title or Position: EXECUTIVE DIRECTOR
Credential: PHARM.D
Phone: 240-460-7060