Healthcare Provider Details

I. General information

NPI: 1902183262
Provider Name (Legal Business Name): VIRAN SENEVIRATNE PHARMD, RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2011
Last Update Date: 03/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1597 KIMBLE WICK ROAD
ROCKVILLE MD
20854
US

IV. Provider business mailing address

1597 KIMBLE WICK ROAD
ROCKVILLE MD
20854
US

V. Phone/Fax

Practice location:
  • Phone: 443-804-3857
  • Fax:
Mailing address:
  • Phone: 443-804-3857
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP438929
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number16360
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI02957500
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number16360
License Number StateMD
# 5
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberRP438929
License Number StatePA
# 6
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number28RI02957500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: