Provider Demographics
NPI:1033551841
Name:DECKER, MORGAN E (RPH)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:E
Last Name:DECKER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20851 ISHERWOOD TER
Mailing Address - Street 2:APT 200
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-7794
Mailing Address - Country:US
Mailing Address - Phone:315-749-6236
Mailing Address - Fax:
Practice Address - Street 1:20851 ISHERWOOD TER
Practice Address - Street 2:APT 200
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-7794
Practice Address - Country:US
Practice Address - Phone:315-749-6236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-22
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202212382183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist