Healthcare Provider Details

I. General information

NPI: 1871883751
Provider Name (Legal Business Name): HENRY UCHECHUKWUKA IWEBOR RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2011
Last Update Date: 04/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1721 E MANNING AVENUE
REEDLEY CA
93654
US

IV. Provider business mailing address

1721 E MANNING AVE RITE AID PHARMACY
REEDLEY CA
93654-9468
US

V. Phone/Fax

Practice location:
  • Phone: 559-638-6349
  • Fax: 559-637-1523
Mailing address:
  • Phone: 559-638-6349
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH61174
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: