MEDICARE: NIKOO FAGHIH RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	19575	MD
2	183500000X	Pharmacist	0202209881	VA

General Provider Information

NPI Number	:	1417240730
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NIKOO FAGHIH RPH

Provider Business Mailing Address
First Line	:	6845 ELM ST STE 105
Second Line	:
City	:	MC LEAN
State	:	VA
Zip	:	22101-3822
Country	:	US
Telephone Number	:	703-338-0828
Fax Number	:	703-388-0826

Provider Business Practice Location Address
First Line	:	6845 ELM ST STE 105
Second Line	:
City	:	MC LEAN
State	:	VA
Zip	:	22101-3822
Country	:	US
Telephone Number	:	703-338-0828
Fax Number	:	703-388-0826

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/19/2011
Last Update Date	:	05/19/2011

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Directions to “ NIKOO FAGHIH RPH” Practice Location

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