Healthcare Provider Details

I. General information

NPI: 1629782537
Provider Name (Legal Business Name): PASCHAL OKAFOR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2023
Last Update Date: 01/06/2023
Certification Date: 01/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1805 S LIMESTONE ST
SPRINGFIELD OH
45505-4015
US

IV. Provider business mailing address

140 KITTY HAWK DR
SPRINGBORO OH
45066-8441
US

V. Phone/Fax

Practice location:
  • Phone: 937-323-5536
  • Fax:
Mailing address:
  • Phone: 937-610-6424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03325795
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: