Healthcare Provider Details

I. General information

NPI: 1871325233
Provider Name (Legal Business Name): KHENI PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2024
Last Update Date: 09/30/2024
Certification Date: 09/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9997 STEDWICK RD
GAITHERSBURG MD
20886-3709
US

IV. Provider business mailing address

9997 STEDWICK RD
GAITHERSBURG MD
20886-3709
US

V. Phone/Fax

Practice location:
  • Phone: 301-363-2400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: NILESH KHENI
Title or Position: OWNER
Credential:
Phone: 267-421-8600