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General NPI Number Information
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NPI Number | 1467652685
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Entity Type | Organization
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Legal Business Name | ETTA I. ONYEMAOBIM
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Dates
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Enumeration Date | 07/25/2007
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Last Update Date | 07/25/2007
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Provider Practice Location Address
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Address Line | 1304 JUNIPER ST
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City | POTTSTOWN
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State | PA
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Zip | 19464-1950
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Country | US
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Telephone | 610-327-9862
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Fax |
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Provider Business Mailing Address
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Address Line | 1304 JUNIPER ST
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City | POTTSTOWN
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State | PA
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Zip | 19464-1950
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ETTA ONYEMAOBIM
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Credential |
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Telephone | 610-327-9862
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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 | RP042404L
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License Number State | PA
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