Provider Demographics
NPI:1104231869
Name:OLUMA, ESSEY (PHARMD)
Entity type:Individual
Prefix:
First Name:ESSEY
Middle Name:
Last Name:OLUMA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 CROWN VIEW DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89523-1524
Mailing Address - Country:US
Mailing Address - Phone:240-425-3430
Mailing Address - Fax:
Practice Address - Street 1:1025 CROWN VIEW DR
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89523-1524
Practice Address - Country:US
Practice Address - Phone:240-425-3430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-20
Last Update Date:2014-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA68151183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist