1225414600 NPI number — DR. CHUKWUDI KEL IHEKIRE PHARMD

Table of content: DR. CHUKWUDI KEL IHEKIRE PHARMD (NPI 1225414600)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225414600 NPI number — DR. CHUKWUDI KEL IHEKIRE PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
IHEKIRE
Provider First Name:
CHUKWUDI
Provider Middle Name:
KEL
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
IHEKIRE
Provider Other First Name:
KEL
Provider Other Middle Name:
CHUKWUDI
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PHARMD
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1225414600
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/07/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9701 BRANCHLEIGH RD APT 2
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RANDALLSTOWN
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21133-2153
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-967-6497
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9701 BRANCHLEIGH RD APT 2
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RANDALLSTOWN
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21133-2153
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-967-6497
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/07/2015

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:  23427 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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