Provider Demographics
NPI:1871701920
Name:PHAMILY PHARMACY
Entity type:Organization
Organization Name:PHAMILY PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GIDEON
Authorized Official - Middle Name:
Authorized Official - Last Name:AKUNJI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-722-0171
Mailing Address - Street 1:6323 GEORGIA AVE NW
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-1101
Mailing Address - Country:US
Mailing Address - Phone:202-722-0171
Mailing Address - Fax:202-722-7580
Practice Address - Street 1:6323 GEORGIA AVE NW STE 100
Practice Address - Street 2:SUITE 100
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-1137
Practice Address - Country:US
Practice Address - Phone:202-722-0171
Practice Address - Fax:202-722-7580
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PHAMILY PHARMACY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-21
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC0903408OtherNABP
DCRX9400241OtherSTATE LICENSE