Edoricia Mariana Guerra
Individual provider Active NPI Pharmacist · Manassas Park, VA
NPI 1699378406 · NPPES record last updated Nov 16, 2020
Key facts
- NPI
- 1699378406
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 0202206375 (VA)
- Practice address
- 7500 Centreville Rd
Manassas Park, VA 20111-1743 - Phone
- (703) 369-1920
- NPI assigned
- Nov 16, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0202206375 | VA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Virginia CVS Pharmacy, L.L.C. | Past |
Accepting new patients | |
| Virginia CVS Pharmacy, L.L.C. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0202206375 | VA | Yes |
Addresses
Primary practice location
7500 Centreville Rd
Manassas Park, VA 20111-1743
Mailing address
7500 Centreville Rd
Manassas Park, VA 20111-1743
Phone (703) 369-1920
Other providers in Manassas Park, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 16, 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.