Healthcare Provider Details

I. General information

NPI: 1134005531
Provider Name (Legal Business Name): AFIA NKANSAH BOAKYE PHARMACIST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

9401 LIBERIA AVE
MANASSAS VA
20110-1718
US

IV. Provider business mailing address

8439 GIRVAN CT
MANASSAS VA
20109-4281
US

V. Phone/Fax

Practice location:
  • Phone: 703-257-0684
  • Fax: 703-257-6356
Mailing address:
  • Phone: 571-778-0987
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202222991
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: