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General NPI Number Information
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NPI Number | 1093083263
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Entity Type | Individual
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Provider Name | EVEREST IFEANYI NWAKAMMA RPH.
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Gender | Male
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Dates
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Enumeration Date | 12/02/2011
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Last Update Date | 12/02/2011
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Provider Practice Location Address
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Address Line | 1452 BETHLEHEM PIKE
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City | FLOURTOWN
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State | PA
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Zip | 19031-2004
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Country | US
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Telephone | 215-836-0128
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Fax | 215-616-1081
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Provider Business Mailing Address
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Address Line | 19 WISMER RD
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City | SCHWENKSVILLE
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State | PA
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Zip | 19473-2835
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Country | US
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Telephone | 610-287-3897
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Fax | 215-616-1081
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 03320231
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP438333
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License Number State | PA
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