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NPI Code Detail

MEDICARE: MR. EFREM MAMO RPH

MEDICARE:  MR. EFREM  MAMO  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
1183500000XPharmacist14256MD

General Provider Information

NPI Number : 1013467927
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. EFREM MAMO RPH
Provider Business Mailing Address
First Line : 6881 NEW HAMPSHIRE AVE
Second Line :
City : TAKOMA PARK
State : MD
Zip : 20912-4816
Country : US
Telephone Number : 301-270-2638
Fax Number : 301-270-2853
Provider Business Practice Location Address
First Line : 6881 NEW HAMPSHIRE AVE
Second Line :
City : TAKOMA PARK
State : MD
Zip : 20912-4816
Country : US
Telephone Number : 301-270-2638
Fax Number : 301-270-2853
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2016
Last Update Date : 10/04/2016

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Directions to “ MR. EFREM MAMO RPH” Practice Location

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