Healthcare Provider Details

I. General information

NPI: 1275664104
Provider Name (Legal Business Name): NEW ERA CARE PHARMACY AND VARIETY OUTLET
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 11/15/2024
Certification Date: 11/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1436 ADDISON RD S
CAPITOL HEIGHTS MD
20743-4413
US

IV. Provider business mailing address

1436 ADDISON RD S
CAPITOL HEIGHTS MD
20743-4413
US

V. Phone/Fax

Practice location:
  • Phone: 301-808-4361
  • Fax: 301-808-5291
Mailing address:
  • Phone: 301-808-4361
  • Fax: 301-808-5291

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MRS. SELINA NWACHUKWU
Title or Position: CEO
Credential: PHARMD
Phone: 301-808-4361