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General NPI Number Information
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NPI Number | 1386738698
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Entity Type | Organization
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Legal Business Name | CHOCOLA DRUGS INC FAIRFAY
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1641 WASHINGTON PLZ N
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City | RESTON
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State | VA
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Zip | 20190-4305
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Country | US
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Telephone | 703-471-4535
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Fax | 703-437-0040
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Provider Business Mailing Address
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Address Line | 1641 WASHINGTON PLZ N
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City | RESTON
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State | VA
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Zip | 20190-4305
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LAWRENCE COHN
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Credential | PHARMACIST
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Telephone | 703-471-4535
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 0201000688
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License Number State | VA
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Taxonomy #2
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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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