Organization
TDS HEALTH
Active
Other names
TDS Health Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
STELLA N. KINTU PHARM D (PHARMACIST)
(703) 878-1837
Entity
Organization
Contact information
Practice address
4215 DALE BLVD, WOODBRIDGE, VA 22193-2243
(703) 457-1049
(571) 659-9028
Mailing address
4215 DALE BLVD, WOODBRIDGE, VA 22193-2243
(034) 571-0497
(571) 659-9028
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1467975565
—
VA
Enumeration date
07/20/2017
Last updated
10/05/2021
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