Herndon Pharmacy and Medical Supply Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

HERNDON PHARMACY AND MEDICAL SUPPLY INC

Practice address

208 Elden St
Herndon, VA 20170-4877

Phone

(202) 257-9240

NPI assigned

Oct 6, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Kamran Agha- Amiri

Title

Ceo

Phone

(202) 257-9240

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1286323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286496000000",
    "number": "1144539289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 S GARFIELD ST",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222041842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 ELDEN ST",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201704877",
            "telephone_number": "202-257-9240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERNDON PHARMACY AND MEDICAL SUPPLY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-06",
        "last_updated": "2010-10-08",
        "status": "A",
        "authorized_official_last_name": "AGHA- AMIRI",
        "authorized_official_first_name": "KAMRAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "202-257-9240",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Retail Pharmacy in Herndon, VA
• Providers in Herndon, VA by specialty
• Community/Retail Pharmacy in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2010; 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.