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General NPI Number Information
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NPI Number | 1184863821
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Entity Type | Organization
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Legal Business Name | MED INC
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Dates
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Enumeration Date | 02/19/2009
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Last Update Date | 02/04/2011
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Provider Practice Location Address
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Address Line | 8401 CONNECTICUT AVE STE 110
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City | CHEVY CHASE
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State | MD
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Zip | 20815-5803
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Country | US
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Telephone | 301-656-7080
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Fax | 301-656-7082
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Provider Business Mailing Address
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Address Line | 505 REDLAND BLVD
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City | ROCKVILLE
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State | MD
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Zip | 20850-5706
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Country | US
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Telephone | 301-656-7080
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Fax | 301-656-7082
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Authorized Official
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Title or Position | PRESIDENT
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Name | ELNAZ DARJ
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Credential |
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Telephone | 301-656-7080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | P04981
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License Number State | MD
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