=====================================================
General NPI Number Information
=====================================================
NPI Number | 1679895940
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ABISHAG ANAAFI OWUSU-AFRIYIE PHARMD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/26/2010
-----------------------------------------------------
Last Update Date | 03/12/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 815 E INNES ST
-----------------------------------------------------
City | SALISBURY
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28144-4625
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 704-638-0764
-----------------------------------------------------
Fax | 704-638-2319
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 810 MAIN ST
-----------------------------------------------------
City | MONROE
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06468-2809
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 203-445-9171
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 0010098
-----------------------------------------------------
License Number State | CT
-----------------------------------------------------