Organization
NOVACARE PHARMACY LLC
Active
Other names
NovaCare Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
VERA ASANTE (MANAGER)
(703) 853-8721
Entity
Organization
Contact information
Practice address
14904 JEFFERSON DAVIS HWY STE 206, WOODBRIDGE, VA 22191-3908
(703) 853-8721
Mailing address
16451 KENNEWEG CT, WOODBRIDGE, VA 22191-6352
(703) 853-8721
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2158062
PK
—
Enumeration date
02/11/2016
Last updated
02/15/2016
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