Healthcare Provider Details

I. General information

NPI: 1184072324
Provider Name (Legal Business Name): OBIAGELI UZOAMAKA OBI PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2016
Last Update Date: 05/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7350 VAN DUSEN RD SUITE 120
LAUREL MD
20707-5263
US

IV. Provider business mailing address

215 HUNTER CREEK DR
YORK PA
17406-6022
US

V. Phone/Fax

Practice location:
  • Phone: 301-604-8500
  • Fax: 301-604-8887
Mailing address:
  • Phone: 301-232-6412
  • Fax: 301-604-8887

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP441218
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number15028
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: