Healthcare Provider Details

I. General information

NPI: 1669383584
Provider Name (Legal Business Name): EMMANUEL POKU RPH
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8904 PRIMULA DR
LAYTONSVILLE MD
20882-3803
US

IV. Provider business mailing address

8904 PRIMULA DR
LAYTONSVILLE MD
20882-3803
US

V. Phone/Fax

Practice location:
  • Phone: 856-467-6103
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number20327
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: