Healthcare Provider Details

I. General information

NPI: 1154232502
Provider Name (Legal Business Name): MARLENE LEI ORTIZ RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 MADISON RD
CULPEPER VA
22701-3405
US

IV. Provider business mailing address

11195 ASHLEE BROOK DR
BEALETON VA
22712-2004
US

V. Phone/Fax

Practice location:
  • Phone: 540-328-1762
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202204161
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: