Healthcare Provider Details

I. General information

NPI: 1467905026
Provider Name (Legal Business Name): AMARACHI ENYINNAYA PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: AMARACHI OTUWA PHARM.D.

II. Dates (important events)

Enumeration Date: 08/01/2016
Last Update Date: 08/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 CRESCENDO DR
MORRISVILLE NC
27560-5724
US

IV. Provider business mailing address

301 CRESCENDO DR
MORRISVILLE NC
27560-5724
US

V. Phone/Fax

Practice location:
  • Phone: 708-465-6143
  • Fax:
Mailing address:
  • Phone: 708-465-6143
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number23017
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number26024191A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: