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General NPI Number Information
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NPI Number | 1386669950
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Entity Type | Organization
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Legal Business Name | THE APOTHECARY INC
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 8316 TRAFORD LN
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City | SPRINGFIELD
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State | VA
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Zip | 22152-1654
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Country | US
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Telephone | 703-451-8990
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Fax | 703-451-8995
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Provider Business Mailing Address
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Address Line | 8316 TRAFORD LN
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City | SPRINGFIELD
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State | VA
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Zip | 22152-1654
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Country | US
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Telephone | 703-451-8990
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Fax | 703-451-8995
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Authorized Official
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Title or Position | PRESIDENT-PHARMACIST IN CHARGE
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Name | LAWRENCE JEROME BURNS
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Credential |
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Telephone | 703-451-8990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0201001712
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License Number State | VA
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