| NPI | 1063156172 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYDIA GEORGY Owner 703-303-6647 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0002X Pharmacy Clinic Pharmacy |
| Additional Taxonomies | 261QM2500X Clinic/Center Medical Specialty |
| 261QP2300X Clinic/Center Primary Care | |
| 3336S0011X Pharmacy Specialty Pharmacy | |
| Enumeration Date | 2022-04-25 |
| Last Update Date | 2022-08-09 |