Organization
SOUTH COUNTY HEALTH CENTER
Active
Other names
South County Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
KOOROSH JEIRAN (CHCN DIRECTOR OF PHARMACY)
(703) 459-7394
Entity
Organization
Contact information
Practice address
8350 RICHMOND HWY, SUITE #301, ALEXANDRIA, VA 22309-2300
(703) 704-6798
(703) 704-6679
Mailing address
8350 RICHMOND HWY, SUITE #301, ALEXANDRIA, VA 22309-2300
(703) 704-6798
(703) 704-6679
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
0201004034
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4843454
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
11/14/2011
Last updated
11/14/2011
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