Organization
MY DR'S PHARMACY
Active
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
Update your record
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