Provider Demographics
NPI:1457619215
Name:ASAMOAH-DARKO, FELIX
Entity Type:Individual
Prefix:
First Name:FELIX
Middle Name:
Last Name:ASAMOAH-DARKO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1690 OLD BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-8006
Mailing Address - Country:US
Mailing Address - Phone:703-494-8000
Mailing Address - Fax:571-572-3647
Practice Address - Street 1:1690 OLD BRIDGE RD
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-8006
Practice Address - Country:US
Practice Address - Phone:703-494-8000
Practice Address - Fax:571-572-3647
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-30
Last Update Date:2022-12-05
Deactivation Date:2022-03-08
Deactivation Code:
Reactivation Date:2022-12-05
Provider Licenses
StateLicense IDTaxonomies
VA0202216242183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist