Healthcare Provider Details

I. General information

NPI: 1790608859
Provider Name (Legal Business Name): CHIDIMMA OKAFOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4201 MEADOWDALE BLVD
NORTH CHESTERFIELD VA
23234-5465
US

IV. Provider business mailing address

4201 MEADOWDALE BLVD
NORTH CHESTERFIELD VA
23234-5465
US

V. Phone/Fax

Practice location:
  • Phone: 804-271-8100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202223370
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: