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NPI Code Detail

MEDICARE: IKECHUKWU WILLY OKWEREKWU RPH

MEDICARE: IKECHUKWU WILLY OKWEREKWU RPH
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
1183500000XPharmacistRP453995PA

General Provider Information

NPI Number : 1285277574
Entity Type Code : Individual
Provider Name (Legal Business Name) : IKECHUKWU WILLY OKWEREKWU RPH
Provider Business Mailing Address
First Line : 7400 ROOSEVELT BLVD
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19152-4318
Country : US
Telephone Number : 617-981-5147
Fax Number :
Provider Business Practice Location Address
First Line : 6515 CASTOR AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19149-2708
Country : US
Telephone Number : 617-981-5147
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2019
Last Update Date : 10/20/2019

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