Mehret Y Banjaw, PHARMACIST
Individual provider Active NPI Pharmacist · Washington, DC
NPI 1104421882 · NPPES record last updated Dec 1, 2020
Key facts
- NPI
- 1104421882
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- PH100001202 (DC)
- Practice address
- 3642 Georgia Ave NW
Washington, DC 20010-1621 - Phone
- (202) 722-2735
- Fax
- (202) 722-4140
- NPI assigned
- Dec 1, 2020
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH100001202 | DC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| District of Columbia CVS Pharmacy, LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH100001202 | DC | Yes |
Addresses
Primary practice location
3642 Georgia Ave NW
Washington, DC 20010-1621
Mailing address
8006 Samuel Wallis St
Lorton, VA 22079-2348
Phone (703) 839-3916
Other providers in Washington, DC
- Sao Y Bangura
- Sulaiman Bangura
- Leen Bani Hani
- Zeina Bani Hani
- Ete Baniaba
- Julie A Banjo
- Oluwafemi Banjo
- William O Bank
- Liknesh L Bankashe
- Michael Bankert
All providers in Washington, DC · Pharmacist in District of Columbia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 1, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.