Healthcare Provider Details

I. General information

NPI: 1952601551
Provider Name (Legal Business Name): PAMELA AMINDEH KEMNGANG PHARMACIST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2010
Last Update Date: 08/18/2022
Certification Date: 08/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13307 NEW HAMPSHIRE AVE
SILVER SPRING MD
20904-3435
US

IV. Provider business mailing address

799 ROCKVILLE PIKE
ROCKVILLE MD
20852-1136
US

V. Phone/Fax

Practice location:
  • Phone: 301-384-0487
  • Fax:
Mailing address:
  • Phone: 301-340-2683
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28577
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: