Revolution Meds Pharmacy, Inc

LBN: Monument-Fairfax, Llc
Revolution Meds Pharmacy, Inc is an health care organization with primary practice located at 11230 Waples Mill Rd Ste 115 , Fairfax VA 22030-5026. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Long Term Care Pharmacy is the primary health care specialty. Monument-Fairfax, Llc can be contacted via phone (703) 899-5947, or through Downing, Patrick F via phone (508) 654-6577.

Contact Information

Primary practice address
11230 Waples Mill Rd Ste 115 Fairfax VA 22030-5026
Phone: (703) 899-5947
Fax: (703) 272-7497
Website:
Map and Directions
Authorized official contact:
Name: Downing, Patrick F
Phone: (508) 654-6577

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Long Term Care Pharmacy 3336L0003X

Profile Details

NPI number 1114475118
LBN Legal business name Monument-Fairfax, Llc
DBA Doing business as Revolution Meds Pharmacy, Inc
Authorized official Downing, Patrick F
Entity Organization
Organization subpart 1 No
Enumeration date Sep 19th, 2016
Last updated Oct 10th, 2023 - about last year

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114475118 NPPES
Other 2164585 PK

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