Provider Demographics
NPI:1215698337
Name:KAMARA, ERNEST PATRICK (PHARMD)
Entity type:Individual
Prefix:
First Name:ERNEST
Middle Name:PATRICK
Last Name:KAMARA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2024 PORT POTOMAC AVE
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-4447
Mailing Address - Country:US
Mailing Address - Phone:571-398-1603
Mailing Address - Fax:
Practice Address - Street 1:16712 JEFFERSON DAVIS HWY
Practice Address - Street 2:
Practice Address - City:DUMFRIES
Practice Address - State:VA
Practice Address - Zip Code:22026-2115
Practice Address - Country:US
Practice Address - Phone:703-221-7467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-02
Last Update Date:2022-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202220153183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist