Healthcare Provider Details

I. General information

NPI: 1730631425
Provider Name (Legal Business Name): OGECHUKWU NDUKWE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2016
Last Update Date: 10/28/2024
Certification Date: 10/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 W ELMSLEY ST
GREENSBORO NC
27406-8276
US

IV. Provider business mailing address

121 W ELMSLEY ST
GREENSBORO NC
27406-8276
US

V. Phone/Fax

Practice location:
  • Phone: 301-530-3666
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number29750
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number24394
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: