Organization
MERCANTILE PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAPIAMBA MUTEBA (CEO)
(301) 404-6067
Entity
Organization
Contact information
Practice address
1400 MERCANTILE LN STE 252, LARGO, MD 20774-5333
(301) 404-6067
Mailing address
3939 S CAPITOL ST SW, WASHINGTON, DC 20032-2308
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
08/22/2022
Last updated
08/22/2022
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