Provider Demographics
NPI:1710223425
Name:SHOMADE, ALBERT (PHARMD)
Entity Type:Individual
Prefix:
First Name:ALBERT
Middle Name:
Last Name:SHOMADE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:AL
Other - Middle Name:
Other - Last Name:SHOMADE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:7304 CARROLL AVE
Mailing Address - Street 2:#105
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-4514
Mailing Address - Country:US
Mailing Address - Phone:301-477-3333
Mailing Address - Fax:
Practice Address - Street 1:1325 14TH ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20005-3610
Practice Address - Country:US
Practice Address - Phone:202-332-8811
Practice Address - Fax:202-332-3880
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-27
Last Update Date:2012-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN64761163W00000X
MDR132831163W00000X
DCPH100000654183500000X
MD19065183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No163W00000XNursing Service ProvidersRegistered Nurse