Provider Demographics
NPI:1629105317
Name:APOTHO DRUG INC.
Entity type:Organization
Organization Name:APOTHO DRUG INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:BRUCE
Authorized Official - Last Name:CHIET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-942-7979
Mailing Address - Street 1:10400 CONNECTICUT AVE
Mailing Address - Street 2:100
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895-3910
Mailing Address - Country:US
Mailing Address - Phone:301-942-7979
Mailing Address - Fax:301-942-5544
Practice Address - Street 1:10400 CONNECTICUT AVE
Practice Address - Street 2:100
Practice Address - City:KENSINGTON
Practice Address - State:MD
Practice Address - Zip Code:20895-3910
Practice Address - Country:US
Practice Address - Phone:301-942-7979
Practice Address - Fax:301-942-5544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2008-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD4099648Medicaid