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General NPI Number Information
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NPI Number | 1497042956
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Entity Type | Organization
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Legal Business Name | NOVA PHARMACY LLC
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Dates
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Enumeration Date | 07/06/2011
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Last Update Date | 05/22/2015
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Provider Practice Location Address
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Address Line | 6023 WILSON BLVD
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City | ARLINGTON
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State | VA
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Zip | 22205-1503
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Country | US
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Telephone | 703-538-5555
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Fax | 703-538-5557
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Provider Business Mailing Address
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Address Line | 6023 WILSON BLVD
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City | ARLINGTON
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State | VA
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Zip | 22205-1503
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Country | US
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Telephone | 703-538-5555
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Fax | 703-538-5557
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Authorized Official
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Title or Position | OWNER,PIC,AO
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Name | TO-UYEN DO
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Credential | PHARMD,RPH
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Telephone | 703-538-5555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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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 | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 0201004419
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License Number State | VA
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