Provider Demographics
NPI:1174312383
Name:MEDITEC PHARMACY LLC
Entity type:Organization
Organization Name:MEDITEC PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GELANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:REGASSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-990-8430
Mailing Address - Street 1:1037 BLADENSBURG RD NE UNIT C2
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-2922
Mailing Address - Country:US
Mailing Address - Phone:202-990-8430
Mailing Address - Fax:202-990-8440
Practice Address - Street 1:1037 BLADENSBURG RD NE UNIT C2
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-2922
Practice Address - Country:US
Practice Address - Phone:202-990-8430
Practice Address - Fax:202-990-8440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy