Healthcare Provider Details

I. General information

NPI: 1972810182
Provider Name (Legal Business Name): BETHRAND IBEH OHAKWEH PHARM. D, B. SC.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2010
Last Update Date: 09/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 WATKINS PARK DR
UPPER MARLBORO MD
20774-1628
US

IV. Provider business mailing address

7006 STORCH LN
LANHAM MD
20706-2176
US

V. Phone/Fax

Practice location:
  • Phone: 301-249-4203
  • Fax: 301-249-4235
Mailing address:
  • Phone: 651-278-4393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number19765
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: