Provider Demographics
NPI:1164546826
Name:OKADIGWE, CYRIL JIDEOFOR (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CYRIL
Middle Name:JIDEOFOR
Last Name:OKADIGWE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 ALLIUM WAY
Mailing Address - Street 2:
Mailing Address - City:TAYLORS
Mailing Address - State:SC
Mailing Address - Zip Code:29687-5461
Mailing Address - Country:US
Mailing Address - Phone:864-525-6501
Mailing Address - Fax:
Practice Address - Street 1:209 ALLIUM WAY
Practice Address - Street 2:
Practice Address - City:TAYLORS
Practice Address - State:SC
Practice Address - Zip Code:29687-5461
Practice Address - Country:US
Practice Address - Phone:864-525-6501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC008738183500000X, 1835G0303X, 1835N1003X, 1835P1200X, 1835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered183500000XPharmacy Service ProvidersPharmacist
Not Answered1835G0303XPharmacy Service ProvidersPharmacistGeriatric
Not Answered1835N1003XPharmacy Service ProvidersPharmacistNutrition Support
Not Answered1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
Not Answered1835X0200XPharmacy Service ProvidersPharmacistOncology