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General NPI Number Information
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NPI Number | 1881053312
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Entity Type | Organization
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Legal Business Name | NOVACARE PHARMACY LLC
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Dates
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Enumeration Date | 02/11/2016
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Last Update Date | 02/15/2016
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Provider Practice Location Address
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Address Line | 14904 JEFFERSON DAVIS HWY STE 206
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City | WOODBRIDGE
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State | VA
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Zip | 22191-3908
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Country | US
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Telephone | 703-853-8721
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Fax |
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Provider Business Mailing Address
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Address Line | 16451 KENNEWEG CT
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City | WOODBRIDGE
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State | VA
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Zip | 22191-6352
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Country | US
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Telephone | 703-853-8721
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | VERA ASANTE
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Credential |
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Telephone | 703-853-8721
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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 | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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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 |
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License Number State |
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Taxonomy #4
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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 #5
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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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