Provider Demographics
NPI:1386931251
Name:ACHUMBA, OBINNA J (PHARMD)
Entity type:Individual
Prefix:
First Name:OBINNA
Middle Name:J
Last Name:ACHUMBA
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:PO BOX 41505
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27629-1505
Mailing Address - Country:US
Mailing Address - Phone:919-779-7779
Mailing Address - Fax:919-424-7185
Practice Address - Street 1:4309 NEW BERN AVE
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-1445
Practice Address - Country:US
Practice Address - Phone:919-231-2858
Practice Address - Fax:919-231-2898
Is Sole Proprietor?:No
Enumeration Date:2011-06-29
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16926183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist