Healthcare Provider Details

I. General information

NPI: 1215101472
Provider Name (Legal Business Name): ALI BAGHERIAN PHARM. D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2008
Last Update Date: 04/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

VETERANS AFFAIRS MEDICAL CENTER 50 IRVING STREET PHARMACY SERVICE 119
WASHINGTON DC
20422-0001
US

IV. Provider business mailing address

VETERANS AFFAIRS MEDICAL CENTER 50 IRVING STREET PHARMACY SERVICE 119
WASHINGTON DC
20422-0001
US

V. Phone/Fax

Practice location:
  • Phone: 202-745-8000
  • Fax: 202-745-8639
Mailing address:
  • Phone: 202-745-8000
  • Fax: 202-745-8639

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number0202011699
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: