MEDICARE: DR. AHUNNA EBERECHI FREEMAN PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	20421	NC

General Provider Information

NPI Number	:	1245519297
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AHUNNA EBERECHI FREEMAN PHARMD

Provider Business Mailing Address
First Line	:	3085 WAUGHTOWN ST
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27107-1634
Country	:	US
Telephone Number	:	336-830-8774
Fax Number	:	336-830-8775

Provider Business Practice Location Address
First Line	:	3085 WAUGHTOWN ST
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27107-1634
Country	:	US
Telephone Number	:	336-830-8774
Fax Number	:	336-830-8775

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2011
Last Update Date	:	12/30/2014

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