Martha Ewing Kophazi, R.PH.
Individual provider Active NPI Pharmacist · Alexandria, VA
NPI 1164027116 · NPPES record last updated Nov 30, 2020
Key facts
- NPI
- 1164027116
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 0202007774 (VA)
- Practice address
- 4800 Fillmore Ave
Alexandria, VA 22311-5070 - Phone
- (703) 820-1061
- Fax
- (703) 824-1353
- NPI assigned
- Nov 30, 2020
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0202007774 | VA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0202007774 | VA | Yes |
Addresses
Primary practice location
4800 Fillmore Ave
Alexandria, VA 22311-5070
Mailing address
4800 Fillmore Ave
Alexandria, VA 22311-5070
Phone (703) 820-1061
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Alexandria | Direct |
Other providers in Alexandria, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 30, 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.