Provider Demographics
NPI:1083304984
Name:MY DR'S APOTHECARY
Entity Type:Organization
Organization Name:MY DR'S APOTHECARY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:SALAM
Authorized Official - Middle Name:
Authorized Official - Last Name:KAMONA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-592-8000
Mailing Address - Street 1:492 ELDEN ST STE B
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20170-4513
Mailing Address - Country:US
Mailing Address - Phone:703-592-8000
Mailing Address - Fax:
Practice Address - Street 1:492 ELDEN ST STE B
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-4513
Practice Address - Country:US
Practice Address - Phone:703-215-8000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-12
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy