Provider Demographics
NPI:1972807998
Name:AKUBUKWE, OBINNA CHUKWUKA (PHARM D)
Entity type:Individual
Prefix:MR
First Name:OBINNA
Middle Name:CHUKWUKA
Last Name:AKUBUKWE
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6006 S. CENTRAL AVENUE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85042
Mailing Address - Country:US
Mailing Address - Phone:602-276-5485
Mailing Address - Fax:602-276-0485
Practice Address - Street 1:6006 S. CENTRAL AVENUE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85042
Practice Address - Country:US
Practice Address - Phone:602-276-5485
Practice Address - Fax:602-276-0485
Is Sole Proprietor?:No
Enumeration Date:2011-01-05
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302033566183500000X
AZS019109183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5302033566OtherRPH LICENSE