Healthcare Provider Details

I. General information

NPI: 1932857281
Provider Name (Legal Business Name): EMMANUEL UCHENNA OPARA RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2022
Last Update Date: 03/15/2022
Certification Date: 03/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

294 ROXALANA HILLS DR
DUNBAR WV
25064-1920
US

IV. Provider business mailing address

294 ROXALANA HILLS DR
DUNBAR WV
25064-1920
US

V. Phone/Fax

Practice location:
  • Phone: 202-594-0743
  • Fax:
Mailing address:
  • Phone: 202-594-0742
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP0012476
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: