Personalmed Virginia Pharmacy Services

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

PERSONALMED VIRGINIA PHARMACY SERVICES

Practice address

12007 Sunrise Valley Dr Ste 110
Reston, VA 20191-3460

Phone

(844) 901-7832

Fax

(281) 305-3989

NPI assigned

Sep 27, 2017

Organization subpart

Yes

Parent organization

PERSONALMED LLCAs reported in NPPES

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

Authorized official

Name

Delford Doherty, PHARM.D., PH.D., MPH

Title

VP Managed Care Services

Phone

(844) 901-7832

Specialties & licenses 3

Addresses

Tax ID family

Personalmed2 organizations share this tax ID, including this one

Part of

Personalmed

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Personalmed

  • Pharmacy
  • Houston, TX
  • NPI 1134626997
  NPD tax ID

Locations

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

{
    "created_epoch": "1506470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1506470400000",
    "number": "1861901340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10370 RICHMOND AVE STE 230",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770424141",
            "telephone_number": "844-901-7832",
            "fax_number": "281-305-3989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12007 SUNRISE VALLEY DR STE 110",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201913460",
            "telephone_number": "844-901-7832",
            "fax_number": "281-305-3989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSONALMED VIRGINIA PHARMACY SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PERSONALMED LLC",
        "enumeration_date": "2017-09-27",
        "last_updated": "2017-09-27",
        "status": "A",
        "authorized_official_last_name": "DOHERTY",
        "authorized_official_first_name": "DELFORD",
        "authorized_official_title_or_position": "VP MANAGED CARE SERVICES",
        "authorized_official_telephone_number": "844-901-7832",
        "authorized_official_credential": "PHARM.D., PH.D., MPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Richard Perez, DDS
• Perfectly Female Women Health Care
• Laura Lynn Peritore, OTR/L
• Tracy Boller Perkins, PA-C
• Christopher R Perron, D.C.
• Pet of Reston, LP
• Jon D Peters, M.D.
• Elizabeth Pettit, MD
• Alexandra Mary Petze, ATC CHES
• Gabrielle Pham-Che, DPT

• Community/Retail Pharmacy in Reston, VA
• Providers in Reston, VA by specialty
• Community/Retail Pharmacy in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2017; 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.