Healthcare Provider Details

I. General information

NPI: 1700740669
Provider Name (Legal Business Name): YEBOAH DUAH-MENSAH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4441 SIX FORKS RD
RALEIGH NC
27609-5729
US

IV. Provider business mailing address

90 JUNIUS BIRCH TRL
FRANKLINTON NC
27525-7716
US

V. Phone/Fax

Practice location:
  • Phone: 919-787-1155
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number34338
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: