Healthcare Provider Details

I. General information

NPI: 1972043370
Provider Name (Legal Business Name): FRANCES EBERECHUKWU OBUTTE PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/03/2017
Last Update Date: 03/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 HIGHLAND AVE
LEWISTOWN PA
17044-1167
US

IV. Provider business mailing address

400 HIGHLAND AVE
LEWISTOWN PA
17044-1167
US

V. Phone/Fax

Practice location:
  • Phone: 717-248-5411
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberRP451246
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: