Healthcare Provider Details

I. General information

NPI: 1548135213
Provider Name (Legal Business Name): NIHA IDREES PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2025
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

661 UNIVERSITY LN STE B
ORANGE VA
22960-2243
US

IV. Provider business mailing address

661 UNIVERSITY LN STE B
ORANGE VA
22960-2243
US

V. Phone/Fax

Practice location:
  • Phone: 540-661-3004
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202222670
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: