MEDICARE: CHYOMA INC

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	332B00000X	Durable Medical Equipment & Medical Supplies
2	3336C0004X	Compounding Pharmacy
3	3336L0003X	Long Term Care Pharmacy
4	3336C0003X	Community/Retail Pharmacy	09918	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3409388	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number	:	1851588339
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHYOMA INC

Provider Business Mailing Address
First Line	:	3500 DAVIS DR
Second Line	:
City	:	MORRISVILLE
State	:	NC
Zip	:	27560-8819
Country	:	US
Telephone Number	:	919-463-7900
Fax Number	:

Provider Business Practice Location Address
First Line	:	3500 DAVIS DR
Second Line	:
City	:	MORRISVILLE
State	:	NC
Zip	:	27560-8819
Country	:	US
Telephone Number	:	919-463-7900
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. CHIOMA UGWA
Credential	:
Telephone Number	:	919-961-0715

Provider Enumeration Date	:	09/28/2007
Last Update Date	:	02/25/2019

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Directions to “CHYOMA INC ” Practice Location

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