Healthcare Provider Details

I. General information

NPI: 1538457023
Provider Name (Legal Business Name): MARTIN M NJOKU RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2011
Last Update Date: 07/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

252 RURAL ACRES DR
BECKLEY WV
25801-3503
US

IV. Provider business mailing address

252 RURAL ACRES DR
BECKLEY WV
25801-3503
US

V. Phone/Fax

Practice location:
  • Phone: 304-252-8324
  • Fax: 304-256-6258
Mailing address:
  • Phone: 304-252-8324
  • Fax: 304-256-6258

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5005
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: