Broad Street Pharmacy
LBN: Broad Street Pharmacy Inc
Broad Street Pharmacy is an health care organization with primary practice located at 450 W Broad St Ste 120 B, Falls Church VA 22046-3340. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy, Suppliers / Specialty Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Broad Street Pharmacy Inc can be contacted via phone (703) 533-9013, or through Ghaderi, Reza via phone (703) 307-2139.
Contact Information
Primary practice address
450 W Broad St Ste 120 B
Falls Church VA 22046-3340
Phone: (703) 533-9013
Fax: (703) 533-9015
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 0201004216 | Virginia |
| Suppliers / Compounding Pharmacy | 3336C0004X | ||
| Suppliers / Specialty Pharmacy | 3336S0011X |
Profile Details
| NPI number | 1598933434 |
|---|---|
| LBN Legal business name | Broad Street Pharmacy Inc |
| DBA Doing business as | Broad Street Pharmacy |
| Authorized official | Ghaderi, Reza RPH |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Feb 13th, 2008 |
| Last updated | May 13th, 2013 - about 11 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1598933434 | NPPES |
| Other | 2106340 | PK |
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