Provider Demographics
NPI:1871921809
Name:AKA LLC
Entity type:Organization
Organization Name:AKA LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NAEIMEH
Authorized Official - Middle Name:
Authorized Official - Last Name:TABARANI
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACY TECH
Authorized Official - Phone:703-629-6089
Mailing Address - Street 1:20701 ASHBURN VALLEY CT
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-4660
Mailing Address - Country:US
Mailing Address - Phone:703-629-6089
Mailing Address - Fax:
Practice Address - Street 1:9830 LIBERIA PHARMACY
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110
Practice Address - Country:US
Practice Address - Phone:703-330-8201
Practice Address - Fax:703-330-8202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-30
Last Update Date:2013-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1942494165OtherPHARMACY