Provider Demographics
NPI:1528369170
Name:FILIPOUR, FATEMEH (RPH)
Entity type:Individual
Prefix:
First Name:FATEMEH
Middle Name:
Last Name:FILIPOUR
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:SOHEYLA
Other - Middle Name:
Other - Last Name:FILIPOUR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:11622 CEDAR CHASE RD
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20170-2476
Mailing Address - Country:US
Mailing Address - Phone:703-948-0095
Mailing Address - Fax:
Practice Address - Street 1:11622 CEDAR CHASE RD
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-2476
Practice Address - Country:US
Practice Address - Phone:703-615-6547
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-14
Last Update Date:2010-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202010848183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist