Healthcare Provider Details

I. General information

NPI: 1912737297
Provider Name (Legal Business Name): AKOSUA OWUSU PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2024
Last Update Date: 08/02/2024
Certification Date: 08/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5910 CLEVELAND AVE
COLUMBUS OH
43231-6881
US

IV. Provider business mailing address

236 GLENKIRK DR
BLACKLICK OH
43004-9392
US

V. Phone/Fax

Practice location:
  • Phone: 614-705-6111
  • Fax:
Mailing address:
  • Phone: 614-674-8107
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03444594
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: