Provider Demographics
NPI:1689719205
Name:RESOURCE PHARMACIES INC
Entity Type:Organization
Organization Name:RESOURCE PHARMACIES INC
Other - Org Name:WELLINGTON APOTHECARY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TAMARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:DUPERVAL-BROWNLEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-325-6220
Mailing Address - Street 1:1160 VARNUM ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20017-2107
Mailing Address - Country:US
Mailing Address - Phone:202-832-2200
Mailing Address - Fax:202-269-7462
Practice Address - Street 1:1160 VARNUM ST NE STE 2
Practice Address - Street 2:SUITE 2
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017-2110
Practice Address - Country:US
Practice Address - Phone:202-832-2200
Practice Address - Fax:202-269-7462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
DCRX88000593336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD453662200Medicaid
DC0981010Medicaid
2004495OtherPK