MRS. MABLE WU WALLACE (NPI# 1144512757) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144512757 |
| Entity Type | Individual |
| Full Name | MRS. MABLE WU WALLACE |
| Practice Address |
20070 Ashbrook Commons Plz Ashburn VA 20147-5034 |
| Mailing Address |
37081 Elaine Pl Purcellville VA 20132-5072 |
| Practice Telephone | 5712230517 |
| Practice Fax Number | 5712230542 |
| Mailing Telephone | 7038019967 |
| Enumeration Date | 2011-05-15 |
| Last Update Date | 2011-05-15 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 0202205009 | VA | Pharmacy Service Providers |
| Street Address |
20070 ASHBROOK COMMONS PLZ |
| City | ASHBURN |
| State | VA |
| Zip Code | 20147-5034 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760576243 | Harris Teeter, LLC | Pharmacy | 20070 Ashbrook Commons Plz, Ashburn, VA 20147-5034 | 2006-10-02 |
| 1376075408 | Tyson Urgent Care, LLC | Clinic/Center | 20070 Ashbrook Commons Plz, Ashburn, VA 20147 | 2017-03-29 |
| 1083151278 | Doran Optometry, Pllc | Optometrist | 20070 Ashbrook Commons Plz, Ste 186, Ashburn, VA 20147-5034 | 2017-01-25 |
| 1972854479 | Minia Isayas | Pharmacist | 20070 Ashbrook Commons Plz, Ashburn, VA 20147-5034 | 2012-09-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750982039 | Smita J Patel | Pharmacist | 43614 Millay Ct., Ashburn, VA 20147 | 2020-11-04 |
| 1740812205 | Ericka N Schmitt | Psychologist | Interchange Psychology, 44075 Pipeline Plaza, Ashburn, VA 20147 | 2020-02-12 |
| 1164065967 | Dorsa Salehi | Behavior Technician | 44933 George Washing Blvd, Suite 115, Ashburn, VA 20147 | 2019-10-24 |
| 1659837094 | Sandrine Shanghai | Case Management | 44933 George Washington Parkway, Suite 110, Ashburn, VA 20147 | 2019-02-11 |
| 1033684154 | Virginia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 44835 Russel Branch Parkway, Ashburn, VA 20147 | 2018-10-04 |
| 1417437203 | Roshni A Patel | Optometrist | 44050 Ashburn Village Blvd, Suite 163, Ashburn, VA 20147 | 2018-08-21 |
| 1972095974 | Verum Cutis Dermatology | Dermatology | 44110 Ashburn Shopping Plz Unit 237, Ashburn, VA 20147 | 2018-06-05 |
| 1033608542 | Justin Leeman | Physical Therapist | 21625 Red Rum Dr, Ashburn, VA 20147 | 2018-05-09 |
| 1255860680 | Aperiomics, Inc. | Clinical Medical Laboratory | 45085 University Dr, Ste 305, Ashburn, VA 20147 | 2017-06-08 |
| 1427591643 | Monecia Michelle Nelms | Counselor | 20925 Professional Plaza, Suite #320, Ashburn, VA 20147 | 2016-11-19 |
| Find all providers in zip 20147 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750982039 | Smita J Patel | Pharmacist | 43614 Millay Ct., Ashburn, VA 20147 | 2020-11-04 |
| 1043819436 | Rajitha Polam | Pharmacist | 43021 Addlestone Pl, Ashburn, VA 20148-6810 | 2020-10-18 |
| 1063010296 | Michael Duggan | Pharmacist | 20547 Waverly Ct, Ashburn, VA 20149-0001 | 2020-10-10 |
| 1518587724 | Desiree Prozeralik | Pharmacist | 22635 Tivoli Ln, Ashburn, VA 20148-7194 | 2020-04-17 |
| 1851935738 | Trishaa Narayan | Pharmacist | 20860 Cardiff Ct, Ashburn, VA 20147-3915 | 2019-11-04 |
| 1922666957 | William Charles Dunn | Pharmacist | 123 E College Ave, Ashburn, GA 31714-5203 | 2019-06-04 |
| 1124590252 | Saul Rodriguez | Pharmacist | 42561 Sunset Ridge Sq, Ashburn, VA 20148-4393 | 2018-12-31 |
| 1477021871 | Dunya Allahwerdy | Pharmacist | 43217 Brookford Sq, Ashburn, VA 20147-5139 | 2018-11-05 |
| 1508340589 | Richard Citrenbaum | Pharmacist | 20226 Kiawah Island Dr, Ashburn, VA 20147-3169 | 2018-09-17 |
| 1790278505 | Andrea Stanford | Pharmacist | 42732 Ogilvie Sq, Ashburn, VA 20148-4182 | 2018-06-07 |
| Find all providers in ASHBURN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.