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General NPI Number Information
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NPI Number | 1194587303
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Entity Type | Organization
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Legal Business Name | EVOLTRIX, LLC
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Dates
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Enumeration Date | 01/24/2024
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Last Update Date | 01/24/2024
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Provider Practice Location Address
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Address Line | 611 S CARLIN SPRINGS RD STE 105
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City | ARLINGTON
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State | VA
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Zip | 22204-1061
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Country | US
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Telephone | 703-379-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 5500 FRIENDSHIP BLVD APT 1822N
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City | CHEVY CHASE
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State | MD
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Zip | 20815-7268
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Country | US
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Telephone | 703-379-4000
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DIPTESHKUMAR PATEL
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Credential |
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Telephone | 703-379-4000
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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 |
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License Number State |
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