Provider Demographics
NPI:1568747053
Name:DARAB, ALI A (R PH)
Entity Type:Individual
Prefix:MR
First Name:ALI
Middle Name:A
Last Name:DARAB
Suffix:
Gender:M
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10580 ARROWHEAD DRIVE
Mailing Address - Street 2:FAIRFAX HEALTH CENTER
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030
Mailing Address - Country:US
Mailing Address - Phone:571-432-2680
Mailing Address - Fax:571-432-2795
Practice Address - Street 1:10580 ARROWHEAD DRIVE
Practice Address - Street 2:FAIRFAX HEALTH CENTER
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030
Practice Address - Country:US
Practice Address - Phone:571-432-2680
Practice Address - Fax:571-432-2795
Is Sole Proprietor?:No
Enumeration Date:2011-10-15
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202010036183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist