Provider Demographics
NPI:1508369570
Name:LANGLEY PHARMACY LLC
Entity Type:Organization
Organization Name:LANGLEY PHARMACY LLC
Other - Org Name:LANGLEY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:AMILCAR
Authorized Official - Middle Name:
Authorized Official - Last Name:ESPINAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-992-7309
Mailing Address - Street 1:3023 HAMAKOW CT STE LL110
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031
Mailing Address - Country:US
Mailing Address - Phone:703-992-7309
Mailing Address - Fax:703-992-6294
Practice Address - Street 1:1515 CHAIN BRIDGE RD STE 103
Practice Address - Street 2:
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-4421
Practice Address - Country:US
Practice Address - Phone:703-992-3709
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-15
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy