Procare Pharmacy Health Center

Primary specialty

PharmacyTaxonomy code 333600000X

License

0201004684 Issued in VA

Legal business name

PROCARE PHARMACY HEALTH CENTER

Practice address

7202 Poplar St Ste E
Annandale, VA 22003-3025

Phone

(571) 830-6583

Fax

(571) 830-6923

NPI assigned

Oct 7, 2015

Organization subpart

No

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

Authorized official

Name

Robyn Doan

Title

Manager

Phone

(571) 830-6583

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Procare Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in DC2 enrollments

Enrollment records 2

Locations

Practitioners 1

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

• Ethan H Bui, PHARMD

  • Pharmacist
  • Annandale, VA
  • NPI 1750978367
  NPD

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

{
    "created_epoch": "1444176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484697600000",
    "number": "1962873695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7202 POPLAR ST",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220033025",
            "telephone_number": "571-830-6583",
            "fax_number": "571-830-6923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7202 POPLAR ST STE E",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220033025",
            "telephone_number": "571-830-6583",
            "fax_number": "571-830-6923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROCARE PHARMACY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-07",
        "last_updated": "2017-01-18",
        "status": "A",
        "authorized_official_last_name": "DOAN",
        "authorized_official_first_name": "ROBYN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "571-830-6583"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "VA",
            "license": "0201004684",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2157326",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Procare Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Primary Gerontology Center LLC
• Primary Health Center, Inc
• Privia Medical Group, LLC
• Privia Medical Group, LLC
• Proactive Chiropractic Corp
• Professional Healthcare Resources Inc
• Professional Healthcare Resources, Inc.
• Progressive Urgent Care PC
• Prohealth Dentists II PLLC
• Prohealth Dentists PLLC

• Pharmacy in Annandale, VA
• Providers in Annandale, VA by specialty
• Pharmacy in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2017; 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.