MEDICARE: IRENE OKEKE PHARMD

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
1	183500000X	Pharmacist	RP449925	PA

General Provider Information

NPI Number	:	1902359508
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IRENE OKEKE PHARMD

Provider Business Mailing Address
First Line	:	1010 ARCH ST UNIT 709
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-3024
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2655 S 10TH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19148-4403
Country	:	US
Telephone Number	:	267-467-6050
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/31/2016
Last Update Date	:	07/31/2016

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Directions to “ IRENE OKEKE PHARMD” Practice Location

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