Provider Demographics
NPI:1306286752
Name:ZALA, ARCHANA
Entity type:Individual
Prefix:
First Name:ARCHANA
Middle Name:
Last Name:ZALA
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 1:12331 GEORGIA AVE STE A
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-3646
Mailing Address - Country:US
Mailing Address - Phone:240-242-3359
Mailing Address - Fax:240-242-3379
Practice Address - Street 1:12331 GEORGIA AVE STE A
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20906-3646
Practice Address - Country:US
Practice Address - Phone:240-242-3359
Practice Address - Fax:240-242-3379
Is Sole Proprietor?:No
Enumeration Date:2013-06-30
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD21477183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist