Healthcare Provider Details

I. General information

NPI: 1477906105
Provider Name (Legal Business Name): CHIMA OHAYA PHARMACIST
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2016
Last Update Date: 07/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25100 HARPER AVE
SAINT CLAIR SHORES MI
48081-2207
US

IV. Provider business mailing address

21863 HIDDEN RIVERS DR N
SOUTHFIELD MI
48075-1008
US

V. Phone/Fax

Practice location:
  • Phone: 586-445-8181
  • Fax: 586-445-8185
Mailing address:
  • Phone: 313-629-7922
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302037784
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: