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Organization
MONUMENT-FAIRFAX, LLC
Active
Organization
MONUMENT-FAIRFAX, LLC
Active
Other names
Revolution Meds Pharmacy, Revolution Meds Pharmacy, INC
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK F DOWNING (COO)
(508) 654-6577
Entity
Organization
Contact information
Practice address
11230 WAPLES MILL RD STE 115, FAIRFAX, VA 22030-5026
(703) 899-5947
(703) 272-7497
Mailing address
11230 WAPLES MILL RD STE 115, FAIRFAX, VA 22030-5026
(703) 899-5947
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336L0003X
Long Term Care Pharmacy
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2164585
PK
—
Enumeration date
09/19/2016
Last updated
10/10/2023
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