Provider Demographics
NPI:1194035741
Name:AGYEI-YEBOAH, FRANK
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:
Last Name:AGYEI-YEBOAH
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 1:24832 JOHN J WILLIAM HWY
Mailing Address - Street 2:
Mailing Address - City:MILLSBORO
Mailing Address - State:DE
Mailing Address - Zip Code:19966
Mailing Address - Country:US
Mailing Address - Phone:302-947-1204
Mailing Address - Fax:302-947-9402
Practice Address - Street 1:24832 JOHN J WILLIAM HWY
Practice Address - Street 2:
Practice Address - City:MILLSBORO
Practice Address - State:DE
Practice Address - Zip Code:19966
Practice Address - Country:US
Practice Address - Phone:302-947-1204
Practice Address - Fax:302-947-9402
Is Sole Proprietor?:No
Enumeration Date:2010-10-18
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0004084183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist