STATE PHARMACY NPI 1205961489

NPI Information

  • NPI: 1205961489
  • Provider Name: STATE PHARMACY
  • Classification: Pharmacy - 3336C0003X
  • Specialization: Community/Retail Pharmacy
  • Entity Type: Organization
  • Address: 2041 MARTIN LUTHER KING AVE
    SUITE 100
    SE WASHINGTON, DC
    ZIP 20020
  • Phone: (202) 610-2100

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NPI Details

STATE PHARMACY is a community/retail pharmacy pharmacy in Se Washington, DC. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. STATE PHARMACY NPI is 1205961489. The provider is registered as an organization entity type.

The provider's business location address is:

2041 MARTIN LUTHER KING AVE
SUITE 100
SE WASHINGTON, DC
ZIP 20020
Phone: (202) 610-2100
Fax: (202) 610-1078

The provider's authorized official is Marie Nkinang Bibum .
The authorized official title is President and has the following contact phone number (202) 610-2100.

The enumeration date for this NPI number is 2/21/2007 and was last updated on 12/1/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332B00000XDurable Medical Equipment & Medical SuppliesNo
2332B00000XDurable Medical Equipment & Medical SuppliesRX0300330DISTRICT OF COLUMBIANo
3333600000XPharmacyNo
43336C0003XPharmacyCommunity/Retail PharmacyRX0300330DISTRICT OF COLUMBIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1034828700MEDICAIDDISTRICT OF COLUMBIA
2035360800MEDICAIDDISTRICT OF COLUMBIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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