Active NPI
King Street Apothecary Inc
- Community/Retail Pharmacy
- Alexandria, VA
National Provider Identifier
1124871959
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- KING STREET APOTHECARY INC
- Practice address
- 4680 King St
Alexandria, VA 22302-1215 - Phone
- (703) 879-3477
- Fax
- (703) 512-4110
- NPI assigned
- Apr 10, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Rahel Yirga, MD
- Title
- Ceo
- Phone
- (703) 879-3477
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | Primary |
Addresses
Primary practice location
4680 King St
Alexandria, VA 22302-1215
Mailing address
4680 King St
Alexandria, VA 22302-1215
Phone (703) 879-3477
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124871959 | Medicaid | VA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20260410001112 | DC | Part B Supplier - Mass Immunization (Roster Biller Only) | 0345722237 | Practice locations: Alexandria, VA |
National Provider Directory
National Provider Directory- Tax ID family
- King Street Apothecary
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Long Term Care Pharmacy
- Alexandria, VA
- NPI 1144041690
-
- Long Term Care Pharmacy
- Alexandria, VA
- NPI 1356162424
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1712707200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1770854400000",
"number": "1124871959",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4680 KING ST",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "223021215",
"telephone_number": "703-879-3477",
"fax_number": "703-512-4110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4680 KING ST",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "223021215",
"telephone_number": "703-879-3477",
"fax_number": "703-512-4110"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KING STREET APOTHECARY INC",
"organizational_subpart": "NO",
"enumeration_date": "2024-04-10",
"last_updated": "2026-02-12",
"certification_date": "2026-02-12",
"status": "A",
"authorized_official_last_name": "YIRGA",
"authorized_official_first_name": "RAHEL",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "703-879-3477",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1124871959",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Alexandria, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.