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NPI Code Detail

MEDICARE: ADWOA EDUSEI RPH

MEDICARE: ADWOA EDUSEI RPH
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
1183500000XPharmacist0202219510VA

General Provider Information

NPI Number : 1003581828
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADWOA EDUSEI RPH
Provider Business Mailing Address
First Line : 1636 CRIM DELL LANE
Second Line :
City : VIENNA
State : VA
Zip : 22182
Country : US
Telephone Number : 703-334-1379
Fax Number :
Provider Business Practice Location Address
First Line : 3507 W CARY ST
Second Line :
City : RICHMOND
State : VA
Zip : 23221-2728
Country : US
Telephone Number : 804-256-6400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/13/2021
Last Update Date : 12/27/2022

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