Organization
PROSPERITY RX FAIRFAX INC
Active
Other names
Prosperity Rx Fairfax, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
FRANK ODEH (PRESIDENT)
(703) 517-4779
Entity
Organization
Contact information
Practice address
2740 PROSPERITY AVE STE 200, FAIRFAX, VA 22031-4354
(703) 334-5180
(703) 620-2030
Mailing address
2740 PROSPERITY AVE, SUITE 200, FAIRFAX, VA 22031-4353
(703) 334-5180
(703) 620-2030
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
0201004617
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2147267
PK
—
Enumeration date
11/21/2014
Last updated
04/24/2017
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