Provider Demographics
NPI:1760662530
Name:DARFOUR, AMMA (RPH)
Entity Type:Individual
Prefix:MRS
First Name:AMMA
Middle Name:
Last Name:DARFOUR
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4424 FORTUNA CENTER PLAZA
Mailing Address - Street 2:
Mailing Address - City:DUMFRIES
Mailing Address - State:VA
Mailing Address - Zip Code:22025
Mailing Address - Country:US
Mailing Address - Phone:703-583-3633
Mailing Address - Fax:703-583-6837
Practice Address - Street 1:12493 DILLINGHAM SQ
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-5257
Practice Address - Country:US
Practice Address - Phone:571-285-1784
Practice Address - Fax:571-285-1958
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-09
Last Update Date:2018-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202204681183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist