Provider Demographics
NPI:1891391348
Name:MEFIRE, AMINA N
Entity Type:Individual
Prefix:
First Name:AMINA
Middle Name:N
Last Name:MEFIRE
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 1:13412 TAMARACK RD
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-1469
Mailing Address - Country:US
Mailing Address - Phone:301-288-7546
Mailing Address - Fax:
Practice Address - Street 1:645 H ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-4347
Practice Address - Country:US
Practice Address - Phone:202-544-1878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-09
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302038704183500000X
DEPH100000519183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC085288500Medicaid