MEDICARE: DR. EDO-ABASI EFFIONG UMOH 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	RPH024101	GA

General Provider Information

NPI Number	:	1437325974
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDO-ABASI EFFIONG UMOH PHARMD

Provider Business Mailing Address
First Line	:	3131 N DRUID HILLS RD
Second Line	:	APT 3302
City	:	DECATUR
State	:	GA
Zip	:	30033-2654
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3131 NORTH DRUID HILLS ROAD
Second Line	:	APARTMENT 3302
City	:	DECATUR
State	:	GA
Zip	:	30033
Country	:	US
Telephone Number	:	401-474-0082
Fax Number	:

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

Provider Enumeration Date	:	05/05/2008
Last Update Date	:	05/05/2008

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