Healthcare Provider Details

I. General information

NPI: 1043680895
Provider Name (Legal Business Name): JUDITH OKAFOR PHARM. D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2015
Last Update Date: 10/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5975 W RAY RD
CHANDLER AZ
85226-1827
US

IV. Provider business mailing address

PO BOX 32554
PHOENIX AZ
85064-2554
US

V. Phone/Fax

Practice location:
  • Phone: 480-214-9120
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberS016414
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202208225
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number62339
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: