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General NPI Number Information
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NPI Number | 1710200068
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Entity Type | Organization
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Legal Business Name | H STREET PHARMACY AND WELLNESS CENTER LLC
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Dates
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Enumeration Date | 03/01/2010
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Last Update Date | 07/16/2015
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Provider Practice Location Address
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Address Line | 812 H ST NE
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City | WASHINGTON
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State | DC
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Zip | 20002-3629
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Country | US
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Telephone | 202-621-9665
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Fax | 202-621-9703
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Provider Business Mailing Address
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Address Line | 812 H ST NE
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City | WASHINGTON
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State | DC
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Zip | 20002-3629
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Country | US
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Telephone | 202-621-9665
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Fax | 202-621-9703
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Authorized Official
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Title or Position | PHARMACIST/OWNER
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Name | KAPIAMBA MUTEBA
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Credential |
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Telephone | 301-404-6067
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty 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 | RX1000420
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License Number State | DC
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