Healthcare Provider Details

I. General information

NPI: 1124858444
Provider Name (Legal Business Name): MARIAN OSAFO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2024
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 WASHINGTON SQUARE PLZ
FREDERICKSBURG VA
22405-3235
US

IV. Provider business mailing address

14 SAINT RICHARDS CT
STAFFORD VA
22556-3670
US

V. Phone/Fax

Practice location:
  • Phone: 540-899-8951
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202222117
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: