Provider Demographics
NPI:1093083263
Name:NWAKAMMA, EVEREST IFEANYI (RPH)
Entity Type:Individual
Prefix:MR
First Name:EVEREST
Middle Name:IFEANYI
Last Name:NWAKAMMA
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 1:19 WISMER RD
Mailing Address - Street 2:
Mailing Address - City:SCHWENKSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19473-2835
Mailing Address - Country:US
Mailing Address - Phone:610-287-3897
Mailing Address - Fax:215-616-1081
Practice Address - Street 1:1452 BETHLEHEM PIKE
Practice Address - Street 2:
Practice Address - City:FLOURTOWN
Practice Address - State:PA
Practice Address - Zip Code:19031-2004
Practice Address - Country:US
Practice Address - Phone:215-836-0128
Practice Address - Fax:215-616-1081
Is Sole Proprietor?:No
Enumeration Date:2011-12-02
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03320231183500000X
PARP438333183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist