Healthcare Provider Details

I. General information

NPI: 1003658899
Provider Name (Legal Business Name): CHUKWUKA ONYEKABA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2024
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3559 CHAMBLEE TUCKER RD
ATLANTA GA
30341-4409
US

IV. Provider business mailing address

3559 CHAMBLEE TUCKER RD
ATLANTA GA
30341-4409
US

V. Phone/Fax

Practice location:
  • Phone: 770-243-6220
  • Fax: 770-243-6224
Mailing address:
  • Phone: 770-243-6220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH034632
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: