Provider Demographics
NPI:1649748211
Name:BARA PHARMACY INC
Entity Type:Organization
Organization Name:BARA PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SEOK YOUN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-334-4513
Mailing Address - Street 1:7700 LITTLE RIVER TPKE STE 103
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-2400
Mailing Address - Country:US
Mailing Address - Phone:703-495-3139
Mailing Address - Fax:703-995-0664
Practice Address - Street 1:7700 LITTLE RIVER TPKE STE 103
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-2400
Practice Address - Country:US
Practice Address - Phone:703-459-3139
Practice Address - Fax:703-995-0664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-12
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy