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General NPI Number Information
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NPI Number | 1760662530
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Entity Type | Individual
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Provider Name | AMMA DARFOUR RPH
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Gender | Female
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Dates
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Enumeration Date | 11/09/2007
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Last Update Date | 12/06/2018
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Provider Practice Location Address
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Address Line | 12493 DILLINGHAM SQ
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City | WOODBRIDGE
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State | VA
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Zip | 22192-5257
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Country | US
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Telephone | 571-285-1784
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Fax | 571-285-1958
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Provider Business Mailing Address
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Address Line | 4424 FORTUNA CENTER PLAZA
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City | DUMFRIES
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State | VA
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Zip | 22025
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Country | US
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Telephone | 703-583-3633
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Fax | 703-583-6837
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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 | 0202204681
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License Number State | VA
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