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General NPI Number Information
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NPI Number | 1114362993
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Entity Type | Organization
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Legal Business Name | MEDEX HEALTH PHARMACY
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Dates
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Enumeration Date | 05/07/2013
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Last Update Date | 05/07/2013
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Provider Practice Location Address
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Address Line | 2835 GALLOWS RD
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City | FALLS CHURCH
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State | VA
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Zip | 22042-1005
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Country | US
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Telephone | 703-208-1840
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Fax |
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Provider Business Mailing Address
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Address Line | 2835 GALLOWS RD
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City | FALLS CHURCH
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State | VA
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Zip | 22042-1005
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHARMACY MANAGER
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Name | MR. MOHAMED ABDALLA
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Credential |
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Telephone | 703-208-1840
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 0201004516
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License Number State | VA
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