Provider Demographics
NPI:1598065682
Name:YUREK, ANNETTE MARIE
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:MARIE
Last Name:YUREK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8646 RICHMOND HWY
Mailing Address - Street 2:SAFEWAY PHARMACY #1283
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22309-4205
Mailing Address - Country:US
Mailing Address - Phone:703-780-3653
Mailing Address - Fax:
Practice Address - Street 1:8646 RICHMOND HWY
Practice Address - Street 2:SAFEWAY PHARMACY #1283
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22309-4205
Practice Address - Country:US
Practice Address - Phone:703-780-3653
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-24
Last Update Date:2010-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202007897183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist