Active NPI
Alemayehu Lemma Mandefro
- Pharmacist
- Front Royal, VA
National Provider Identifier
1659679702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0202204483
- Practice address
- 800 John Marshall Hwy
Front Royal, VA 22630-4577 - Phone
- (540) 631-0332
- NPI assigned
- Mar 13, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 | 0202204483 | VA | Primary |
| Pharmacist | 183500000X | RP0007415 | WV |
Addresses
Primary practice location
800 John Marshall Hwy
Front Royal, VA 22630-4577
Mailing address
800 John Marshall Hwy
Front Royal, VA 22630-4577
Phone (571) 214-2910
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 |
|---|---|---|---|
| 0202204483 | VA | MD | Pharmacist |
| RP0007415 | WV | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1299974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1299974400000",
"number": "1659679702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 JOHN MARSHALL HWY",
"city": "FRONT ROYAL",
"state": "VA",
"postal_code": "226304577",
"telephone_number": "571-214-2910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 JOHN MARSHALL HWY",
"city": "FRONT ROYAL",
"state": "VA",
"postal_code": "226304577",
"telephone_number": "540-631-0332"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANDEFRO",
"first_name": "ALEMAYEHU",
"middle_name": "LEMMA",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-03-13",
"last_updated": "2011-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202204483",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WV",
"license": "RP0007415",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Front Royal, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.