MEDICARE: DR. ELISA KATHRYN SANGRIU 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	0202222259	VA
2	183500000X	Pharmacist	29897	MD

General Provider Information

NPI Number	:	1699503615
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELISA KATHRYN SANGRIU PHARMD

Provider Business Mailing Address
First Line	:	4000 GARDEN CITY DR DEPT 6TH
Second Line	:
City	:	HYATTSVILLE
State	:	MD
Zip	:	20785-2418
Country	:	US
Telephone Number	:	571-654-0006
Fax Number	:

Provider Business Practice Location Address
First Line	:	4000 GARDEN CITY DR DEPT 6TH
Second Line	:
City	:	HYATTSVILLE
State	:	MD
Zip	:	20785-2418
Country	:	US
Telephone Number	:	571-654-0006
Fax Number	:

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

Provider Enumeration Date	:	07/22/2024
Last Update Date	:	08/31/2024

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