MEDICARE: DR. SONTHEARY AMEI KEM PHARM-D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	0202206958	VA

General Provider Information

NPI Number	:	1003122961
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SONTHEARY AMEI KEM PHARM-D

Provider Business Mailing Address
First Line	:	7100 AYERS MEADOW LN
Second Line	:
City	:	SPRINGFIELD
State	:	VA
Zip	:	22150-4915
Country	:	US
Telephone Number	:	240-463-3174
Fax Number	:

Provider Business Practice Location Address
First Line	:	6711 RICHMOND HWY
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22306-6712
Country	:	US
Telephone Number	:	703-768-7233
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/28/2010
Last Update Date	:	10/31/2014

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