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General NPI Number Information
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NPI Number | 1346974839
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Entity Type | Organization
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Legal Business Name | WEAVE DR APOTHECARY
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Dates
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Enumeration Date | 07/12/2022
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Last Update Date | 07/12/2022
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Provider Practice Location Address
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Address Line | 3231 SUPERIOR LN STE A21
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City | BOWIE
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State | MD
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Zip | 20715-1934
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Country | US
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Telephone | 703-973-7146
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Fax | 240-245-2102
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Provider Business Mailing Address
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Address Line | 12138 CENTRAL AVE # 221
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City | BOWIE
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State | MD
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Zip | 20721-1910
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Country | US
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Telephone | 703-973-7146
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Fax | 240-245-2102
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Authorized Official
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Title or Position | OWNER
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Name | CHELSEA MITCHELL
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Credential |
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Telephone | 703-973-7146
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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