Individual provider Active NPI

Selma Mitiche

  • Pharmacist
  • Alexandria, VA
National Provider Identifier
1184029431
Registry record updated Oct 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH100001825 Issued in DC
Practice address
3101 Jefferson Davis Hwy
Alexandria, VA 22305-3042
Phone
(703) 706-3840
NPI assigned
Oct 29, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH100001825 DC Primary
Pharmacist 183500000X 26025849A IN

Addresses

Primary practice location

3101 Jefferson Davis Hwy
Alexandria, VA 22305-3042

Mailing address

1301 Massachusetts Ave NW
Apt 307
Washington, DC 20005-4162

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PH100001825DCMDPharmacist
26025849AINMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1414540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414540800000",
    "number": "1184029431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 MASSACHUSETTS AVE NW",
            "address_2": "APT 307",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200054162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 JEFFERSON DAVIS HWY",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223053042",
            "telephone_number": "703-706-3840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITICHE",
        "first_name": "SELMA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-29",
        "last_updated": "2014-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "DC",
            "license": "PH100001825",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26025849A",
            "primary": false
        }
    ],
    "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 29, 2014; 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.