Provider Demographics
NPI:1215329503
Name:AMFO-ANTIRI, KWASI
Entity type:Individual
Prefix:
First Name:KWASI
Middle Name:
Last Name:AMFO-ANTIRI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1474 MAIN ST. HAMILTON
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45013
Mailing Address - Country:US
Mailing Address - Phone:513-868-6578
Mailing Address - Fax:513-868-8056
Practice Address - Street 1:1474 HAMILTON RICHMOND RD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013-1074
Practice Address - Country:US
Practice Address - Phone:513-868-6578
Practice Address - Fax:513-868-8056
Is Sole Proprietor?:No
Enumeration Date:2015-02-24
Last Update Date:2015-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH031296891835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric