Active NPI
Eric Cudiamat
- Pharmacist
- Alexandria, VA
National Provider Identifier
1316552037
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0202219065
- Practice address
- 6717 Richmond Hwy
Alexandria, VA 22306-6704 - Phone
- (703) 721-0912
- NPI assigned
- Sep 10, 2020
- Last updated
- Sep 10, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0202219065 | VA | Primary |
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 0202219065 | VA |
Addresses
Primary practice location
6717 Richmond Hwy
Alexandria, VA 22306-6704
Mailing address
6717 Richmond Hwy
Alexandria, VA 22306-6704
Phone (703) 721-0912
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0202219065 | VA | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
6717 Richmond Hwy
Alexandria, VA 22306
Phone (703) 721-0912
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599696000000",
"number": "1316552037",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6717 RICHMOND HWY",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "223066704",
"telephone_number": "703-721-0912"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6717 RICHMOND HWY",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "223066704",
"telephone_number": "703-721-0912"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CUDIAMAT",
"first_name": "ERIC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-09-10",
"last_updated": "2020-09-10",
"certification_date": "2020-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202219065",
"primary": true
},
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "VA",
"license": "0202219065",
"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 Sep 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.