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General NPI Number Information
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NPI Number | 1306145875
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Entity Type | Individual
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Provider Name | RICHMOND G NIMAKO-BOATENG PHARM.D, RPH
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Gender | Male
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Dates
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Enumeration Date | 03/23/2011
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Last Update Date | 03/23/2011
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Provider Practice Location Address
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Address Line | 1677 MONTGOMERY RD SUITE 110-112
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City | AURORA
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State | IL
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Zip | 60504-8802
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Country | US
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Telephone | 630-236-9502
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4863
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City | NAPERVILLE
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State | IL
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Zip | 60567-4863
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Country | US
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Telephone | 630-236-9502
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Fax |
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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 | 051287405
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 051287405
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License Number State | IL
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