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NPI Code Detail

MEDICARE: PETWORTH CARE PHARMACY

MEDICARE: PETWORTH CARE PHARMACY
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
13336C0003XCommunity/Retail PharmacyRX0500337DC

General Provider Information

NPI Number : 1467596577
Entity Type Code : Organization
Provider Name (Legal Business Name) : PETWORTH CARE PHARMACY
Provider Business Mailing Address
First Line : 4809 GEORGIA AVE NW
Second Line :
City : WASHINGTON
State : DC
Zip : 20011-4533
Country : US
Telephone Number : 202-722-4330
Fax Number : 202-722-7143
Provider Business Practice Location Address
First Line : 4809 GEORGIA AVE NW
Second Line :
City : WASHINGTON
State : DC
Zip : 20011-4533
Country : US
Telephone Number : 202-722-4330
Fax Number : 202-722-7143
Authorized Official
Title or Position : PHARMACIST INCHARGE
Name : MESFIN GEGZIABHEAR
Credential : RPH
Telephone Number : 202-722-4330
Provider Enumeration Date : 02/20/2007
Last Update Date : 08/22/2020

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Directions to “PETWORTH CARE PHARMACY ” Practice Location

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