# MEDICAL FACULTY ASSOCIATES INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** GW MEDICAL FACULTY ASSOCIATES PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750324083
- **Authorized official:** DR. RYAN MOUTON PHARM. D. (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (202) 741-2218

## Contact information

- **Practice address:** 2150 PENNSYLVANIA AVE NW, \# G201, WASHINGTON, DC 20037-3201
- **Practice address phone:** (202) 741-3600
- **Practice address fax:** (202) 741-3606
- **Mailing address:** 2150 PENNSYLVANIA AVE NW, \# G201, WASHINGTON, DC 20037-3201
- **Mailing address phone:** (202) 741-3600
- **Mailing address fax:** (202) 741-3606

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0002X | Clinic Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | RX0000301 | DC | Yes |
| 3336S0011X | Specialty Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 06/14/2006
- **Last updated:** 08/31/2023