Healthcare Provider Details
I. General information
NPI: 1447894928
Provider Name (Legal Business Name): VACCINE VALET LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/29/2019
Last Update Date: 10/07/2021
Certification Date: 10/07/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4800 HAMPDEN LN STE 214
BETHESDA MD
20814-2930
US
IV. Provider business mailing address
PO BOX 15213
CHEVY CHASE MD
20825-5213
US
V. Phone/Fax
- Phone: 240-277-4892
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336S0011X |
| Taxonomy | Specialty Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
EMILY
SHEWMAKER
Title or Position: MANAGER
Credential: PHARM.D
Phone: 240-277-4892