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General NPI Number Information
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NPI Number | 1215545306
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Entity Type | Organization
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Legal Business Name | VPKT SHAH RX LLC
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Dates
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Enumeration Date | 07/15/2020
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Last Update Date | 07/15/2020
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Provider Practice Location Address
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Address Line | 10 SAINT PATRICKS DR
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City | WALDORF
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State | MD
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Zip | 20603-4527
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Country | US
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Telephone | 240-925-4305
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Fax |
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Provider Business Mailing Address
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Address Line | 15207 SMOKEHOUSE ROW LN
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City | CHARLOTTE HALL
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State | MD
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Zip | 20622-3369
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Country | US
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Telephone | 240-925-4305
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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 | PRAKRUTI SHAH
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Credential |
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Telephone | 240-925-4305
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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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