Healthcare Provider Details

I. General information

NPI: 1871701920
Provider Name (Legal Business Name): PHAMILY PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 06/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6323 GEORGIA AVE NW STE 100 SUITE 100
WASHINGTON DC
20011-1137
US

IV. Provider business mailing address

6323 GEORGIA AVE NW SUITE 100
WASHINGTON DC
20011-1101
US

V. Phone/Fax

Practice location:
  • Phone: 202-722-0171
  • Fax: 202-722-7580
Mailing address:
  • Phone: 202-722-0171
  • Fax: 202-722-7580

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 Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: GIDEON AKUNJI
Title or Position: PHARMACIST OWNER
Credential:
Phone: 202-722-0171