Healthcare Provider Details

I. General information

NPI: 1508536426
Provider Name (Legal Business Name): TAHA YASEEN TOKHI PHARMD.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2021
Last Update Date: 09/14/2021
Certification Date: 09/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 W LEE ST UNIT 102
WARRENTON VA
20186-3255
US

IV. Provider business mailing address

77 W LEE ST UNIT 102
WARRENTON VA
20186-3255
US

V. Phone/Fax

Practice location:
  • Phone: 703-966-7853
  • Fax: 540-216-3698
Mailing address:
  • Phone: 703-966-7853
  • Fax: 540-216-3698

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202212120
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: