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General NPI Number Information
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NPI Number | 1912754938
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Entity Type | Individual
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Provider Name | UWAILA OMOROGBE
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Gender | Male
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Dates
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Enumeration Date | 05/06/2024
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Last Update Date | 08/19/2024
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Provider Practice Location Address
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Address Line | 400 HIGHLAND AVE
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City | LEWISTOWN
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State | PA
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Zip | 17044-1167
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Country | US
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Telephone | 717-248-5411
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Fax |
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Provider Business Mailing Address
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Address Line | 301 CHESTNUT ST APT 2507
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City | HARRISBURG
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State | PA
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Zip | 17101-2761
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Country | US
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Telephone | 410-858-7117
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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 | RP458736
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License Number State | PA
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