Healthcare Provider Details
I. General information
NPI: 1841550274
Provider Name (Legal Business Name): CHIDINMA CATHERINE OBASI P.PHARM
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/18/2012
Last Update Date: 05/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7953 CRAIN HWY S
GLEN BURNIE MD
21061-4934
US
IV. Provider business mailing address
5640 THELO GARTH
COLUMBIA MD
21045-2546
US
V. Phone/Fax
- Phone: 410-969-3417
- Fax:
- Phone: 443-413-6415
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | 17083 |
| License Number State | MD |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: