Provider Demographics
NPI:1124391321
Name:OFORI, EMMANUEL DEREK (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:EMMANUEL
Middle Name:DEREK
Last Name:OFORI
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 COCHRAN DR
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-6432
Mailing Address - Country:US
Mailing Address - Phone:214-264-6520
Mailing Address - Fax:
Practice Address - Street 1:3901 COCHRAN DR
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-6432
Practice Address - Country:US
Practice Address - Phone:214-264-6520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-17
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX44847183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist