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General NPI Number Information
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NPI Number | 1124704044
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Entity Type | Organization
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Legal Business Name | ANNOVEX PHARMA, INC
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Dates
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Enumeration Date | 06/26/2023
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Last Update Date | 06/26/2023
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Provider Practice Location Address
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Address Line | 7403 LOCKPORT PL SUITE C
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City | LORTON
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State | VA
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Zip | 22079-1153
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Country | US
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Telephone | 571-642-5262
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Fax |
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Provider Business Mailing Address
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Address Line | 7403 LOCKPORT PL SUITE C
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City | LORTON
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State | VA
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Zip | 22079-1153
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Country | US
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Telephone | 571-642-5262
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. ADEDAYO AKINBI
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Credential | PHARMD
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Telephone | 571-366-5316
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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