Provider Demographics
NPI:1033615349
Name:NKWENTI, RICHARD NJI (RPH)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:NJI
Last Name:NKWENTI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15331 W BELL RD STE 122
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-4103
Mailing Address - Country:US
Mailing Address - Phone:623-404-1000
Mailing Address - Fax:623-256-6491
Practice Address - Street 1:15331 W BELL RD STE 122
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-4103
Practice Address - Country:US
Practice Address - Phone:623-404-1000
Practice Address - Fax:623-256-6491
Is Sole Proprietor?:No
Enumeration Date:2018-04-04
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS015754183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist