Healthcare Provider Details

I. General information

NPI: 1073999199
Provider Name (Legal Business Name): OKOIA UKET PHARM.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2015
Last Update Date: 07/31/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 E COMMERCE ST
HERNANDO MS
38632-2433
US

IV. Provider business mailing address

950 E COMMERCE ST
HERNANDO MS
38632-2433
US

V. Phone/Fax

Practice location:
  • Phone: 662-429-3349
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberE-13944
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: