Organization
AKA LLC
Active
Other names
liberia pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NAEIMEH TABARANI PHARMACY TECH (OWNER)
(703) 629-6089
Entity
Organization
Contact information
Practice address
9830 LIBERIA PHARMACY, MANASSAS, VA 20110
(703) 330-8201
(703) 330-8202
Mailing address
20701 ASHBURN VALLEY CT, ASHBURN, VA 20147-4660
(703) 629-6089
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1942494165
PHARMACY
VA
Enumeration date
10/30/2013
Last updated
10/30/2013
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