Organization
FREDERICKSBURG CITY PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOGES KIFLE TEKLE PHARM.D (CEO/ PRESIDENT)
(703) 772-0773
Entity
Organization
Contact information
Practice address
4500 PLANK RD STE 1024, FREDERICKSBURG, VA 22407-0120
(540) 479-1405
(540) 370-8990
Mailing address
4500 PLANK RD STE 10244500, FREDERICKSBURG, VA 22407-0120
(540) 479-1405
(540) 370-8990
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
0201004460
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1083148290
—
VA
Enumeration date
04/13/2017
Last updated
07/14/2025
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