MEDICARE: H STREET PHARMACY AND WELLNESS CENTER LLC

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	3336S0011X	Specialty Pharmacy
2	3336C0003X	Community/Retail Pharmacy	RX1000420	DC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2124002	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710200068
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	H STREET PHARMACY AND WELLNESS CENTER LLC

Provider Business Mailing Address
First Line	:	812 H ST NE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20002-3629
Country	:	US
Telephone Number	:	202-621-9665
Fax Number	:	202-621-9703

Provider Business Practice Location Address
First Line	:	812 H ST NE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20002-3629
Country	:	US
Telephone Number	:	202-621-9665
Fax Number	:	202-621-9703

Authorized Official
Title or Position	:	PHARMACIST/OWNER
Name	:	KAPIAMBA MUTEBA
Credential	:
Telephone Number	:	301-404-6067

Provider Enumeration Date	:	03/01/2010
Last Update Date	:	07/16/2015

Similar Medicare Providers

1760666838 — MS. MIRIAM MCNEIL M, ED, LPC
Practice Location Address:

816 H ST NE
WASHINGTON, DC
20002-3629

Practice Phone: 202-548-0096
Practice Fax: 202-548-0199

1841527447 — KAPIAMBA MUTEBA
Practice Location Address:

812 H ST NE
WASHINGTON, DC
20002-3629

Practice Phone: 301-404-6067
Practice Fax: 301-404-6067

1457887531 — FIGHTIN4LIVES, LLC
Practice Location Address:

812 H ST NE , SUITE B
WASHINGTON, DC
20002-3629

Practice Phone: 202-869-3743
Practice Fax:

1215596085 — POTOMAC SUPPLY COMPANY LLC
Practice Location Address:

820 H ST NE STE 201
WASHINGTON, DC
20002-3629

Practice Phone: 202-341-6070
Practice Fax: 888-395-0772

1790776110 — ST JOSEPHS REHABILITATION & RESIDENCE
Practice Location Address:

1133 WASHINGTON AVE
PORTLAND, ME
04103-3629

Practice Phone: 207-797-0600
Practice Fax: 207-797-4168

1871697532 — VIRGINIA CVS PHARMACY, L.L.C.
Practice Location Address:

433 S WASHINGTON ST
ALEXANDRIA, VA
22314-3629

Practice Phone: 703-836-7668
Practice Fax:

Directions to “H STREET PHARMACY AND WELLNESS CENTER LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.