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General NPI Number Information
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NPI Number | 1447913785
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Entity Type | Individual
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Provider Name | BASILIA OKWUCHI
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Gender | Female
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Dates
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Enumeration Date | 10/13/2021
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Last Update Date | 10/13/2021
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Provider Practice Location Address
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Address Line | 8301 PROFESSIONAL PL
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City | LANDOVER
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State | MD
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Zip | 20785-2237
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Country | US
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Telephone | 703-216-0896
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Fax |
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Provider Business Mailing Address
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Address Line | 8002 RIVER FIELD CT
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City | BOWIE
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State | MD
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Zip | 20715-3305
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Country | US
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Telephone | 240-486-2986
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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 | 0202219691
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License Number State | VA
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