MEDICARE: MIGNON TALA SCHLEY PHARMD

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	0202207671	VA
2	183500000X	Pharmacist	20080	MD

General Provider Information

NPI Number	:	1396036257
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIGNON TALA SCHLEY PHARMD

Provider Business Mailing Address
First Line	:	6600 SPRINGFIELD MALL
Second Line	:
City	:	SPRINGFIELD
State	:	VA
Zip	:	22150
Country	:	US
Telephone Number	:	703-921-9003
Fax Number	:	703-921-9003

Provider Business Practice Location Address
First Line	:	6600 SPRINGFIELD MALL
Second Line	:
City	:	SPRINGFIELD
State	:	VA
Zip	:	22150-1712
Country	:	US
Telephone Number	:	703-921-9003
Fax Number	:	703-921-9003

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

Provider Enumeration Date	:	04/27/2011
Last Update Date	:	04/27/2011

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