Organization Active NPI

Nova Pharmacy LLC

  • Community/Retail Pharmacy
  • Arlington, VA
National Provider Identifier
1497042956
Registry record updated May 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
0201004419 Issued in VA
Legal business name
NOVA PHARMACY LLC
Practice address
6023 Wilson Blvd
Arlington, VA 22205-1503
Phone
(703) 538-5555
Fax
(703) 538-5557
NPI assigned
Jul 6, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2015

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

Authorized official

Name
To-Uyen DO, PHARMD,RPHNPI 1801488176
Title
Owner,Pic,Ao
Phone
(703) 538-5555

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 0201004419 VA Primary
Compounding Pharmacy 3336C0004X

Addresses

Primary practice location

6023 Wilson Blvd
Arlington, VA 22205-1503

Mailing address

6023 Wilson Blvd
Arlington, VA 22205-1503
Phone (703) 538-5555

Other identifiers 2

IdentifierTypeStateIssuer
2130996OtherPK
1497042956MedicaidVA

Other names 1

  • NoVA Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120126000360 DC Part B Supplier - Mass Immunization (Roster Biller Only) 9537336938 Practice locations: Arlington, VA

National Provider Directory

National Provider Directory

Locations

6023 Wilson Blvd
Arlington, VA 22205
Phone (703) 538-5555

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1309910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432252800000",
    "number": "1497042956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6023 WILSON BLVD",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222051503",
            "telephone_number": "703-538-5555",
            "fax_number": "703-538-5557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6023 WILSON BLVD",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222051503",
            "telephone_number": "703-538-5555",
            "fax_number": "703-538-5557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVA PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-06",
        "last_updated": "2015-05-22",
        "status": "A",
        "authorized_official_last_name": "DO",
        "authorized_official_first_name": "TO-UYEN",
        "authorized_official_title_or_position": "OWNER,PIC,AO",
        "authorized_official_telephone_number": "703-538-5555",
        "authorized_official_credential": "PHARMD,RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "VA",
            "license": "0201004419",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2130996",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1497042956",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NoVA Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Arlington, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.