Healthcare Provider Details

I. General information

NPI: 1447633409
Provider Name (Legal Business Name): UCHECHUKWU JANET EYISI PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2015
Last Update Date: 07/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6260 CRAIN HWY
LA PLATA MD
20646-4258
US

IV. Provider business mailing address

511 HARRY S TRUMAN DR APT 407
LARGO MD
20774-2073
US

V. Phone/Fax

Practice location:
  • Phone: 301-934-9564
  • Fax:
Mailing address:
  • Phone: 267-455-2329
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number19290
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: