MEDICARE: ALPHA CARE 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	332B00000X	Durable Medical Equipment & Medical Supplies
2	3336S0011X	Specialty Pharmacy
3	3336C0004X	Compounding Pharmacy
4	333600000X	Pharmacy
5	3336L0003X	Long Term Care Pharmacy
6	3336C0003X	Community/Retail Pharmacy	RX1200009	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	RX2200172	OTHER	DC	PHARMACY PERMIT

General Provider Information

NPI Number	:	1548520612
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALPHA CARE PHARMACY INC

Provider Business Mailing Address
First Line	:	1638 R ST NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20009-6446
Country	:	US
Telephone Number	:	202-265-7979
Fax Number	:	202-265-0588

Provider Business Practice Location Address
First Line	:	1638 R ST NW STE 1
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20009-6446
Country	:	US
Telephone Number	:	202-265-7979
Fax Number	:	202-265-0589

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	JAN HERMINA
Credential	:
Telephone Number	:	469-667-3352

Provider Enumeration Date	:	05/23/2012
Last Update Date	:	03/04/2026

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