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General NPI Number Information
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NPI Number | 1245245851
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Entity Type | Organization
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Legal Business Name | BLUE DOOR PHARMACIES
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Dates
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Enumeration Date | 07/30/2006
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Last Update Date | 03/31/2015
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Provider Practice Location Address
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Address Line | 15225 SHADY GROVE RD SUITE 101
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City | ROCKVILLE
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State | MD
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Zip | 20850-3254
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Country | US
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Telephone | 301-948-4222
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Fax | 301-948-0018
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Provider Business Mailing Address
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Address Line | 15225 SHADY GROVE RD SUITE 101
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City | ROCKVILLE
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State | MD
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Zip | 20850-3254
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Country | US
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Telephone | 301-948-4222
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Fax | 301-948-0018
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Authorized Official
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Title or Position | OWNER
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Name | SHEILA ALIZADEH
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Credential |
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Telephone | 240-731-2813
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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 | P05361
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License Number State | MD
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