Provider Demographics
NPI:1730580101
Name:THAKKER, ARCHANA
Entity type:Individual
Prefix:MRS
First Name:ARCHANA
Middle Name:
Last Name:THAKKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12215 DARNESTOWN RD
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-2203
Mailing Address - Country:US
Mailing Address - Phone:301-948-8010
Mailing Address - Fax:301-208-8215
Practice Address - Street 1:12215 DARNESTOWN RD
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-2203
Practice Address - Country:US
Practice Address - Phone:301-948-8010
Practice Address - Fax:301-208-8215
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-04
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18350000X183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist