Provider Demographics
NPI:1386122695
Name:ALLOU, JACQUES NDAKPAGNI (PHARMD)
Entity type:Individual
Prefix:
First Name:JACQUES
Middle Name:NDAKPAGNI
Last Name:ALLOU
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 1:7330 WYANDOT LN
Mailing Address - Street 2:
Mailing Address - City:LIBERTY TOWNSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:45044-9700
Mailing Address - Country:US
Mailing Address - Phone:513-349-5742
Mailing Address - Fax:
Practice Address - Street 1:146 WOODMAN DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45431-1423
Practice Address - Country:US
Practice Address - Phone:937-781-3120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-30
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03337897183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist