Healthcare Provider Details

I. General information

NPI: 1245155365
Provider Name (Legal Business Name): MAHDIEH MOSLEMI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1875 ELECTRIC RD
SALEM VA
24153-7207
US

IV. Provider business mailing address

216 BAIER DR
SALEM VA
24153-7163
US

V. Phone/Fax

Practice location:
  • Phone: 540-378-1996
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202220605
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: