Healthcare Provider Details

I. General information

NPI: 1376409540
Provider Name (Legal Business Name): ANGELA E. HAN PHARMD, BCOP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/31/2025
Last Update Date: 12/31/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8081 INNOVATION PARK DRIVE
FAIRFAX VA
22031
US

IV. Provider business mailing address

8081 INNOVATION PARK DRIVE
FAIRFAX VA
22031
US

V. Phone/Fax

Practice location:
  • Phone: 571-472-1180
  • Fax: 571-472-1197
Mailing address:
  • Phone: 571-472-1180
  • Fax: 571-472-1197

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number0202204276
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: