Provider Demographics
NPI:1235341967
Name:IGBOEMEKA, BENJAMIN OBUEKWE (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:OBUEKWE
Last Name:IGBOEMEKA
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8420 CARROLLTON PKWY
Mailing Address - Street 2:
Mailing Address - City:NEW CARROLLTON
Mailing Address - State:MD
Mailing Address - Zip Code:20784-2732
Mailing Address - Country:US
Mailing Address - Phone:301-518-9653
Mailing Address - Fax:
Practice Address - Street 1:2203 DEFENSE HIGHWAY
Practice Address - Street 2:
Practice Address - City:CROFTON
Practice Address - State:MD
Practice Address - Zip Code:21114
Practice Address - Country:US
Practice Address - Phone:410-721-6239
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD11343183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist