Provider Demographics
NPI:1831949924
Name:ASHBURN PHARMACY LLC
Entity type:Organization
Organization Name:ASHBURN PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY OWNER/ IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:MOHANAD
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-991-3168
Mailing Address - Street 1:43150 BROADLANDS CENTER PLZ STE 150
Mailing Address - Street 2:
Mailing Address - City:BROADLANDS
Mailing Address - State:VA
Mailing Address - Zip Code:20148-3801
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:43150 BROADLANDS CENTER PLZ STE 150
Practice Address - Street 2:
Practice Address - City:BROADLANDS
Practice Address - State:VA
Practice Address - Zip Code:20148-3801
Practice Address - Country:US
Practice Address - Phone:571-479-4125
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy