Provider Demographics
NPI:1972811354
Name:EGBUKWU, OSINAKACHI EJIKE (PHARMD)
Entity type:Individual
Prefix:
First Name:OSINAKACHI
Middle Name:EJIKE
Last Name:EGBUKWU
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 1:1600 EDGMONT AVE
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19013-5325
Mailing Address - Country:US
Mailing Address - Phone:610-874-7600
Mailing Address - Fax:
Practice Address - Street 1:1600 EDGMONT AVE
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19013-5325
Practice Address - Country:US
Practice Address - Phone:610-874-7600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-20
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP441043183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist