Organization
PHARMACY ONE LLC
Active
Other names
PHARMACY ONE, Pharmacy One LLC
Organization subpart
No
Provider details
NPI number
Authorized official
FARHAD KHAMISSIZADEH (PHARMACIST)
(703) 910-6044
Entity
Organization
Contact information
Practice address
14904 JEFFERSON DAVIS HWY STE 101, WOODBRIDGE, VA 22191-3908
(703) 910-6044
Mailing address
14904 JEFFERSON DAVIS HWY STE 101, WOODBRIDGE, VA 22191-3908
(703) 910-6044
(571) 572-3174
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1528691946
—
VA
Enumeration date
02/13/2020
Last updated
04/29/2020
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