Provider Demographics
NPI:1164703591
Name:ECHE, EDITH NKECHINYERE
Entity Type:Individual
Prefix:
First Name:EDITH
Middle Name:NKECHINYERE
Last Name:ECHE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 S MARIETTA PKWY SW
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30064-3288
Mailing Address - Country:US
Mailing Address - Phone:770-420-8932
Mailing Address - Fax:770-420-9513
Practice Address - Street 1:23 S MARIETTA PKWY SW
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-3288
Practice Address - Country:US
Practice Address - Phone:770-420-8932
Practice Address - Fax:770-420-9513
Is Sole Proprietor?:No
Enumeration Date:2011-08-30
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH022666183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist