Organization
TYSONS PHARMACY INC
Active
Organization
TYSONS PHARMACY INC
Active
Other names
TYSONS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
BIJAN AHMADI RPH (PRESIDENT/MANAGER)
(571) 338-3502
Entity
Organization
Contact information
Practice address
110 PLEASANT ST NW UNIT C, VIENNA, VA 22180-4447
(703) 992-7083
(703) 992-7253
Mailing address
110 PLEASANT ST NW, UNIT C, VIENNA, VA 22180-4447
(703) 992-7083
(703) 992-7253
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
0201004309
VA
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2121331
PK
—
Enumeration date
12/19/2008
Last updated
04/05/2017
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