MEDICARE: DR. CHIGBO NNANNA EKWUEME PHARM.D

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	68093	TX

General Provider Information

NPI Number	:	1912591678
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHIGBO NNANNA EKWUEME PHARM.D

Provider Business Mailing Address
First Line	:	4006 ESTES PKWY
Second Line	:
City	:	LONGVIEW
State	:	TX
Zip	:	75603-1712
Country	:	US
Telephone Number	:	208-323-4903
Fax Number	:

Provider Business Practice Location Address
First Line	:	4006 ESTES PKWY
Second Line	:
City	:	LONGVIEW
State	:	TX
Zip	:	75603-1712
Country	:	US
Telephone Number	:	903-234-2083
Fax Number	:

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

Provider Enumeration Date	:	02/23/2021
Last Update Date	:	02/23/2021

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