Provider Demographics
NPI:1154860187
Name:PHARMACARE USA
Entity Type:Organization
Organization Name:PHARMACARE USA
Other - Org Name:SKYLINE PHARMACY & CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:YASIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDALLAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-417-9074
Mailing Address - Street 1:5100 LEESBURG PIKE STE 101
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22302-1000
Mailing Address - Country:US
Mailing Address - Phone:703-417-9074
Mailing Address - Fax:
Practice Address - Street 1:5100 LEESBURG PIKE STE 101
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22302-1000
Practice Address - Country:US
Practice Address - Phone:703-417-9074
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-23
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QM1300X
VA333600000X, 3336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No333600000XSuppliersPharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy