Provider Demographics
NPI:1326761800
Name:LARYEA, EKUA (PHARMD)
Entity Type:Individual
Prefix:
First Name:EKUA
Middle Name:
Last Name:LARYEA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:EKUA
Other - Middle Name:
Other - Last Name:ENCHILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9940 OH-43
Mailing Address - Street 2:
Mailing Address - City:STREETSBORO
Mailing Address - State:OH
Mailing Address - Zip Code:44241
Mailing Address - Country:US
Mailing Address - Phone:330-626-1866
Mailing Address - Fax:330-626-9801
Practice Address - Street 1:9940 OH-43
Practice Address - Street 2:
Practice Address - City:STREETSBORO
Practice Address - State:OH
Practice Address - Zip Code:44241
Practice Address - Country:US
Practice Address - Phone:330-626-1866
Practice Address - Fax:330-626-9801
Is Sole Proprietor?:No
Enumeration Date:2022-09-20
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03441363183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist