Healthcare Provider Details

I. General information

NPI: 1306420096
Provider Name (Legal Business Name): VICTORIA U OKEREKE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2021
Last Update Date: 05/08/2021
Certification Date: 05/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9801 GREENBELT RD STE 207
LANHAM MD
20706-6227
US

IV. Provider business mailing address

9801 GREENBELT RD STE 207
LANHAM MD
20706-6227
US

V. Phone/Fax

Practice location:
  • Phone: 301-552-8755
  • Fax: 301-552-8770
Mailing address:
  • Phone: 301-552-8755
  • Fax: 301-552-8770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number14536
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: