Provider Demographics
NPI:1801970355
Name:ALKAYSI, HANAN N
Entity type:Individual
Prefix:
First Name:HANAN
Middle Name:N
Last Name:ALKAYSI
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:DTHC PENTAGON PHARMACY
Mailing Address - Street 2:5801 DEFENSE PENTAGON
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20310-0001
Mailing Address - Country:US
Mailing Address - Phone:703-692-8692
Mailing Address - Fax:703-692-0899
Practice Address - Street 1:DTHC PENTAGON PHARMACY
Practice Address - Street 2:5801 DEFENSE PENTAGON
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20310-0001
Practice Address - Country:US
Practice Address - Phone:703-692-8692
Practice Address - Fax:703-692-0899
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2009-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202011976183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist