Organization
MY DR'S PHARMACY
Active
Other names
My Dr's Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIL MANNA RPH (OWNER, PIC, AO)
(703) 215-8000
Entity
Organization
Contact information
Practice address
492 ELDEN ST, HERNDON, VA 20170-4513
(703) 215-8000
(703) 955-7558
Mailing address
492 ELDEN ST, HERNDON, VA 20170-4513
(703) 215-8000
(703) 955-7558
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
—
—
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
0201004708
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1629426648
—
VA
01
—
2160792
PK
—
Enumeration date
05/31/2016
Last updated
09/19/2023
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