| NPI | 1629780101 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA D SPENCER Pharmacist In Charge 703-817-2170 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2022-12-15 |
| Last Update Date | 2023-06-15 |