Individual
MEKONEN AMBAYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7041 MARTIN LUTHER KING JR HWY, HYATTSVILLE, MD 20785-4016
(301) 386-6141
(301) 386-2772
Mailing address
7041 MARTIN LUTHER KING JR HWY, HYATTSVILLE, MD 20785-4016
(301) 386-6141
(301) 386-2772
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14041
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1306944137
CVS
—
Enumeration date
08/07/2017
Last updated
07/21/2022
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