Provider Demographics
NPI:1245630144
Name:GARCIA, DESIREE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:DESIREE
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:DESIREE
Other - Middle Name:
Other - Last Name:ROBERTSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD,
Mailing Address - Street 1:14390 CHANTILLY CROSSING LN
Mailing Address - Street 2:PHARMACY DEPARTMENT
Mailing Address - City:CHANTILLY
Mailing Address - State:VA
Mailing Address - Zip Code:20151-2117
Mailing Address - Country:US
Mailing Address - Phone:703-885-5546
Mailing Address - Fax:703-885-5564
Practice Address - Street 1:14390 CHANTILLY CROSSING LN
Practice Address - Street 2:PHARMACY DEPARTMENT
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20151-2117
Practice Address - Country:US
Practice Address - Phone:703-885-5546
Practice Address - Fax:703-885-5564
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-27
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA26314183500000X
VA02022078351835P0018X
VA0202207832183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist