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General NPI Number Information
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NPI Number | 1700300506
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Entity Type | Organization
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Legal Business Name | PHARMASUTRA PLLC
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Dates
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Enumeration Date | 08/02/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 7963 HERITAGE VILLAGE PLZ
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City | GAINESVILLE
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State | VA
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Zip | 20155-3077
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Country | US
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Telephone | 703-743-5603
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Fax |
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Provider Business Mailing Address
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Address Line | 7963 HERITAGE VILLAGE PLZ
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City | GAINESVILLE
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State | VA
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Zip | 20155-3077
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Country | US
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Telephone | 703-743-5603
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Fax |
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Authorized Official
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Title or Position | PHARMACIST/OWNER
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Name | MR. DAVINDER PAL KAHLON
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Credential | PHARM D
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Telephone | 703-743-5603
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 0201004481
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License Number State | VA
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