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NPI Code Detail

MEDICARE: MRS. EMELYN MILLS WEYANDT RPH

MEDICARE: MRS. EMELYN MILLS WEYANDT RPH
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
1183500000XPharmacist0202005264VA

General Provider Information

NPI Number : 1932409968
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. EMELYN MILLS WEYANDT RPH
Provider Business Mailing Address
First Line : 2500 N HARRISON ST
Second Line : SAFEWAY PHARMACY 0764
City : ARLINGTON
State : VA
Zip : 22207-1600
Country : US
Telephone Number : 703-538-6911
Fax Number : 703-538-6138
Provider Business Practice Location Address
First Line : 2500 N HARRISON ST
Second Line : SAFEWAY PHARMACY 0764
City : ARLINGTON
State : VA
Zip : 22207-1600
Country : US
Telephone Number : 703-538-6911
Fax Number : 703-538-6138
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2010
Last Update Date : 10/25/2010

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