Provider Demographics
NPI:1386669950
Name:THE APOTHECARY INC
Entity Type:Organization
Organization Name:THE APOTHECARY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT-PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:JEROME
Authorized Official - Last Name:BURNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-451-8990
Mailing Address - Street 1:8316 TRAFORD LN
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22152-1654
Mailing Address - Country:US
Mailing Address - Phone:703-451-8990
Mailing Address - Fax:703-451-8995
Practice Address - Street 1:8316 TRAFORD LN
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22152-1654
Practice Address - Country:US
Practice Address - Phone:703-451-8990
Practice Address - Fax:703-451-8995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0201001712183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty