Provider Demographics
NPI:1669405296
Name:GARCIA-PENA, EDNA (RPH)
Entity type:Individual
Prefix:MRS
First Name:EDNA
Middle Name:
Last Name:GARCIA-PENA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9214 LONG BRANCH PARKWAY
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901
Mailing Address - Country:US
Mailing Address - Phone:202-782-5298
Mailing Address - Fax:202-782-4236
Practice Address - Street 1:6900 GEORGIA AVE NW
Practice Address - Street 2:BLDG 2 PHARMACY DEPARTMENT
Practice Address - City:WALTER REED ARMY MEDICAL CENTER
Practice Address - State:DC
Practice Address - Zip Code:20307-5001
Practice Address - Country:US
Practice Address - Phone:202-782-5298
Practice Address - Fax:202-782-4236
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-08
Last Update Date:2008-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS 28381183500000X, 1835N0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835N0905XPharmacy Service ProvidersPharmacistNuclear