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General NPI Number Information
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NPI Number | 1699219980
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Entity Type | Organization
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Legal Business Name | ADVENTIST HEALTHCARE INC
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Dates
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Enumeration Date | 12/06/2016
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Last Update Date | 04/10/2017
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Provider Practice Location Address
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Address Line | 7600 CARROLL AVE OUTPATIENT PHARMACY
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City | TAKOMA PARK
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State | MD
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Zip | 20912-6367
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Country | US
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Telephone | 301-891-6625
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Fax | 301-891-6208
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Provider Business Mailing Address
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Address Line | 7600 CARROLL AVE OUTPATIENT PHARMACY
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City | TAKOMA PARK
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State | MD
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Zip | 20912-6367
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Country | US
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Telephone | 301-891-6625
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF PHARMACY
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Name | CHRIS GOOD
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Credential |
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Telephone | 814-244-4813
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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 |
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License Number State |
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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 | P07417
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License Number State | MD
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