Provider Demographics
NPI:1144354218
Name:SIERRA INTERNATIONAL PHARMACAUTICAL
Entity type:Organization
Organization Name:SIERRA INTERNATIONAL PHARMACAUTICAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:PUWO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-232-1455
Mailing Address - Street 1:3316 14TH ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-2302
Mailing Address - Country:US
Mailing Address - Phone:202-232-1455
Mailing Address - Fax:
Practice Address - Street 1:3316 14TH ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2302
Practice Address - Country:US
Practice Address - Phone:202-232-1455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC025933200332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies