Organization
KHAA LLC
Active
Other names
Liberty Pharmacy & Medical Supplies
Organization subpart
No
Provider details
NPI number
Authorized official
NAEIMEH TABARANI (OWNER)
(703) 629-6686
Entity
Organization
Contact information
Practice address
19465 DEERFIELD AVE STE 107, LEESBURG, VA 20176-1702
(703) 629-6089
Mailing address
19465 DEERFIELD AVE STE 107, LEESBURG, VA 20176-1702
(703) 629-6089
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
03/30/2021
Last updated
04/30/2021
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