Provider Demographics
NPI:1033278825
Name:P&M PHARMACY, INC
Entity Type:Organization
Organization Name:P&M PHARMACY, INC
Other - Org Name:CATHEDRAL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MANAGER / SP
Authorized Official - Prefix:MR
Authorized Official - First Name:SATISH
Authorized Official - Middle Name:
Authorized Official - Last Name:YELAMANCHILI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-265-1300
Mailing Address - Street 1:3000 CONNECTICUT AVE NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20008-2509
Mailing Address - Country:US
Mailing Address - Phone:202-265-1300
Mailing Address - Fax:202-234-5832
Practice Address - Street 1:3000 CONNECTICUT AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-2509
Practice Address - Country:US
Practice Address - Phone:202-265-1300
Practice Address - Fax:202-234-5832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-07
Last Update Date:2016-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRX88000183336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC019671100Medicaid
0901822OtherNCPDP
0901822OtherNCPDP