NPIMap

Organization Active NPI

King Street Apothecary

  • Long Term Care Pharmacy
  • Alexandria, VA
National Provider Identifier
1144041690
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
KING STREET APOTHECARY
Practice address
4680 King St
Alexandria, VA 22302-1215
Phone
(703) 879-3477
Fax
(703) 512-4110
NPI assigned
Oct 17, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Benyam Mitiku, PHARMD
Title
Owner/Pic
Phone
(703) 879-3477

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X 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

National Provider Directory

National Provider Directory
Tax ID family
King Street Apothecary3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1729123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729123200000",
    "number": "1144041690",
    "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",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-17",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A",
        "authorized_official_last_name": "MITIKU",
        "authorized_official_first_name": "BENYAM",
        "authorized_official_title_or_position": "OWNER/PIC",
        "authorized_official_telephone_number": "703-879-3477",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Oct 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.