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General NPI Number Information
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NPI Number | 1801195219
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Entity Type | Organization
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Legal Business Name | MEDEX PHARMACY LLC
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Dates
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Enumeration Date | 03/24/2011
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Last Update Date | 10/08/2012
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Provider Practice Location Address
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Address Line | 6845 ELM ST STE 105
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City | MC LEAN
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State | VA
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Zip | 22101-3822
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Country | US
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Telephone | 703-388-0828
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Fax | 703-388-0826
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Provider Business Mailing Address
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Address Line | 6845 ELM ST STE 105
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City | MC LEAN
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State | VA
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Zip | 22101-3822
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Country | US
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Telephone | 703-388-0828
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Fax | 703-388-0826
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Authorized Official
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Title or Position | PHARMACY MANAGER
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Name | MR. MOHAMED ABDALLA
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Credential |
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Telephone | 703-388-0828
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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 |
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License Number State |
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