Provider Demographics
NPI:1982356614
Name:PRESTON'S COMPOUNDING, INC. DBA TELESTAR PHARMACY
Entity Type:Organization
Organization Name:PRESTON'S COMPOUNDING, INC. DBA TELESTAR PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PAEANO
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:703-216-2533
Mailing Address - Street 1:2924 TELESTAR CT
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-1206
Mailing Address - Country:US
Mailing Address - Phone:571-341-8787
Mailing Address - Fax:443-524-1209
Practice Address - Street 1:2924 TELESTAR CT
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-1206
Practice Address - Country:US
Practice Address - Phone:571-341-8787
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-24
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy