Provider Demographics
NPI:1508445396
Name:RAFI, FARANGIS
Entity Type:Individual
Prefix:
First Name:FARANGIS
Middle Name:
Last Name:RAFI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:177 THOMAS JOHNSON DR STE B
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-5104
Mailing Address - Country:US
Mailing Address - Phone:301-682-3220
Mailing Address - Fax:301-682-3775
Practice Address - Street 1:177 THOMAS JOHNSON DR STE B
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-5104
Practice Address - Country:US
Practice Address - Phone:301-682-3220
Practice Address - Fax:301-682-3775
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-07
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD16775183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist