Healthcare Provider Details

I. General information

NPI: 1912994161
Provider Name (Legal Business Name): MORRIS OGONJI LWENYA RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2005
Last Update Date: 09/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1139 7TH ST
WASCO CA
93280-1819
US

IV. Provider business mailing address

2201 TILDEN WAY
BAKERSFIELD CA
93309-4389
US

V. Phone/Fax

Practice location:
  • Phone: 661-758-0123
  • Fax: 661-758-2398
Mailing address:
  • Phone: 661-835-9686
  • Fax: 661-758-2398

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number47601
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: