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General NPI Number Information
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NPI Number | 1154986800
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Entity Type | Organization
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Legal Business Name | EBENEZER FAMILY PHARMACY INC
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Dates
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Enumeration Date | 05/08/2019
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Last Update Date | 05/08/2019
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Provider Practice Location Address
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Address Line | 1416 LANCASTER AVE
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City | WILMINGTON
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State | DE
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Zip | 19805-3905
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Country | US
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Telephone | 302-652-1994
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Fax | 302-652-6960
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Provider Business Mailing Address
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Address Line | PO BOX 30410
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City | WILMINGTON
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State | DE
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Zip | 19805-7410
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Country | US
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Telephone | 302-652-1994
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Fax | 302-652-6960
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | DR. NWAKAEGO A CHUKWUNENYE
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Credential | PHARMACIST
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Telephone | 302-652-1994
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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