Organization
OMM INC
Active
Other names
Medicine Shoppe
Organization subpart
No
Provider details
NPI number
Authorized official
MR. AMIT Y SHAH RPH (OWNER)
(703) 491-7883
Entity
Organization
Contact information
Practice address
14454 JEFFERSON DAVIS HWY, WOODBRIDGE, VA 22191-2806
(703) 491-7883
(703) 491-7923
Mailing address
14454 JEFFERSON DAVIS HWY, WOODBRIDGE, VA 22191-2806
(703) 491-7883
(703) 491-7923
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
0201003734
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4836005
NCPDP #
VA
Enumeration date
09/26/2006
Last updated
03/07/2023
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