Healthcare Provider Details

I. General information

NPI: 1932490497
Provider Name (Legal Business Name): IJEOMA AGNES UWAKWE PHARM.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2011
Last Update Date: 02/19/2025
Certification Date: 02/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

404 EAST NASH ST
WILSON NC
27893-0000
US

IV. Provider business mailing address

4226 GEORGETOWN DR N
WILSON NC
27896-9505
US

V. Phone/Fax

Practice location:
  • Phone: 252-293-4177
  • Fax:
Mailing address:
  • Phone: 252-293-4177
  • Fax: 252-293-4180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number20339
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: