Provider Demographics
NPI:1902363542
Name:CHOURAICHI, SAFAE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SAFAE
Middle Name:
Last Name:CHOURAICHI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6030 MADISON OVERLOOK CT
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22041-3651
Mailing Address - Country:US
Mailing Address - Phone:202-821-6789
Mailing Address - Fax:
Practice Address - Street 1:8505 ARLINGTON BLVD
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4621
Practice Address - Country:US
Practice Address - Phone:703-970-6555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-01
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA02022127051835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology