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NPI Code Detail

MEDICARE: VINCENT C EGWUONWU PHARMACIST

MEDICARE: VINCENT C EGWUONWU PHARMACIST
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist51327TX

General Provider Information

NPI Number : 1366044927
Entity Type Code : Individual
Provider Name (Legal Business Name) : VINCENT C EGWUONWU PHARMACIST
Provider Business Mailing Address
First Line : 247 BENWICK DR
Second Line :
City : SUNNYVALE
State : TX
Zip : 75182-3256
Country : US
Telephone Number : 214-502-3162
Fax Number :
Provider Business Practice Location Address
First Line : 1200 W MAIN ST
Second Line :
City : GUN BARREL CITY
State : TX
Zip : 75156-5320
Country : US
Telephone Number : 903-887-2133
Fax Number : 903-887-3566
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2020
Last Update Date : 11/09/2020

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