Healthcare Provider Details

I. General information

NPI: 1558994137
Provider Name (Legal Business Name): KALORAMA PHARMACY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2020
Last Update Date: 02/21/2020
Certification Date: 02/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1841 COLUMBIA RD NW
WASHINGTON DC
20009-2059
US

IV. Provider business mailing address

1841 COLUMBIA RD NW
WASHINGTON DC
20009-2059
US

V. Phone/Fax

Practice location:
  • Phone: 202-795-9711
  • Fax:
Mailing address:
  • Phone: 202-795-9711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM FADEL
Title or Position: CHAIRMAN
Credential:
Phone: 703-943-7292