Provider Demographics
NPI:1073207015
Name:JOE-LOUIS, CASSANDRA (RPH)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:JOE-LOUIS
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 1:43824 DODGE TER APT 103
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-4751
Mailing Address - Country:US
Mailing Address - Phone:571-403-4496
Mailing Address - Fax:
Practice Address - Street 1:46965 CEDAR LAKE PLZ
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20164-8653
Practice Address - Country:US
Practice Address - Phone:703-430-3328
Practice Address - Fax:703-430-8203
Is Sole Proprietor?:No
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202221037183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist