Provider Demographics
NPI:1043240427
Name:CHINWUBAH, STELLA U (RPH)
Entity Type:Individual
Prefix:
First Name:STELLA
Middle Name:U
Last Name:CHINWUBAH
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 E FLETCHER AVE
Mailing Address - Street 2:STE 101
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-3707
Mailing Address - Country:US
Mailing Address - Phone:813-558-9300
Mailing Address - Fax:813-558-9333
Practice Address - Street 1:2001 E FLETCHER AVE
Practice Address - Street 2:STE 101
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-3707
Practice Address - Country:US
Practice Address - Phone:813-558-9300
Practice Address - Fax:813-558-9333
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS29295183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist