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General NPI Number Information
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NPI Number | 1538722145
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Entity Type | Individual
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Provider Name | CHARLENE FAIRFAX RPH
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Gender | Female
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Dates
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Enumeration Date | 04/18/2019
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Last Update Date | 04/18/2019
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Provider Practice Location Address
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Address Line | 441 4TH ST NW STE 900
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City | WASHINGTON
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State | DC
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Zip | 20001-2714
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Country | US
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Telephone | 202-442-9076
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Fax | 202-722-5685
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Provider Business Mailing Address
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Address Line | 9 EVARTS ST NE
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City | WASHINGTON
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State | DC
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Zip | 20002-1005
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Country | US
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Telephone | 202-904-6560
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PHA2782
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License Number State | DC
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