Healthcare Provider Details

I. General information

NPI: 1710591151
Provider Name (Legal Business Name): ZIMUZOH ORAKWUE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2020
Last Update Date: 09/02/2020
Certification Date: 09/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1202 NATIONAL HWY
LAVALE MD
21502-7603
US

IV. Provider business mailing address

121 BLACKFORD DR
STEPHENSON VA
22656-1960
US

V. Phone/Fax

Practice location:
  • Phone: 301-729-1004
  • Fax:
Mailing address:
  • Phone: 347-971-5239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202218959
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number27461
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: