Healthcare Provider Details
I. General information
NPI: 1790641694
Provider Name (Legal Business Name): CRI DC LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/05/2026
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1444 I ST NW STE 100
WASHINGTON DC
20005-2200
US
IV. Provider business mailing address
1444 I ST NW STE 100
WASHINGTON DC
20005-2200
US
V. Phone/Fax
- Phone: 202-759-5200
- Fax: 202-759-5200
- Phone: 202-759-5200
- Fax: 202-759-5200
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ETHAN
BLAKE
WHEELER
Title or Position: COMPLIANCE OFFICER
Credential: PHARMD
Phone: 202-773-0805