MEDICARE: MEDISCRIPT PHARMACY INC

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	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	0201002487	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2102626	OTHER		PK

General Provider Information

NPI Number	:	1548367386
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDISCRIPT PHARMACY INC

Provider Business Mailing Address
First Line	:	2946 SLEEPY HOLLOW RD
Second Line	:
City	:	FALLS CHURCH
State	:	VA
Zip	:	22044-2003
Country	:	US
Telephone Number	:	703-532-8989
Fax Number	:	703-532-3198

Provider Business Practice Location Address
First Line	:	2946 SLEEPY HOLLOW RD
Second Line	:
City	:	FALLS CHURCH
State	:	VA
Zip	:	22044-2003
Country	:	US
Telephone Number	:	703-532-8989
Fax Number	:	703-532-3198

Authorized Official
Title or Position	:	PRESIDENT
Name	:	TIEN HOANG
Credential	:	RPH
Telephone Number	:	703-532-8989

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	05/03/2022

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Directions to “MEDISCRIPT PHARMACY INC ” Practice Location

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