Provider Demographics
NPI:1073118691
Name:OSAKWE, CHIBUNDU
Entity Type:Individual
Prefix:
First Name:CHIBUNDU
Middle Name:
Last Name:OSAKWE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 SCENIC CT
Mailing Address - Street 2:
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-1745
Mailing Address - Country:US
Mailing Address - Phone:201-349-6929
Mailing Address - Fax:
Practice Address - Street 1:1100 S HIGH ST
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-1521
Practice Address - Country:US
Practice Address - Phone:540-433-1158
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202218397183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist