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General NPI Number Information
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NPI Number | 1932766219
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Entity Type | Individual
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Provider Name | KENNEDY EBERECHUKWU OHAEGBU PHARMD
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Gender | Male
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Dates
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Enumeration Date | 05/22/2019
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Last Update Date | 05/22/2019
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Provider Practice Location Address
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Address Line | 3489 SEMINOLE TRL
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22911-5637
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Country | US
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Telephone | 434-964-1082
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Fax |
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Provider Business Mailing Address
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Address Line | 1523 DELPHI LN
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22911-3658
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Country | US
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Telephone | 301-302-3210
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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 | 0202217230
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License Number State | VA
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