1114257565 NPI number — MR. ISAAC OKECHUKWU OKOYE R.PH

Table of content: MR. ISAAC OKECHUKWU OKOYE R.PH (NPI 1114257565)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114257565 NPI number — MR. ISAAC OKECHUKWU OKOYE R.PH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
OKOYE
Provider First Name:
ISAAC
Provider Middle Name:
OKECHUKWU
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
R.PH
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1114257565
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/07/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
19450 LORAIN RD
Provider Second Line Business Mailing Address:
APT # 210W
Provider Business Mailing Address City Name:
FAIRVIEW PARK
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44126-1975
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
440-356-1073
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
PINON ROUTE 4
Provider Second Line Business Practice Location Address:
AT PINON PHARMACY
Provider Business Practice Location Address City Name:
PINON
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85610
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
928-725-9500
Provider Business Practice Location Address Fax Number:
928-725-9542
Provider Enumeration Date:
01/07/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  03316871 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com