Provider Demographics
NPI:1346986676
Name:AZU, NGOZI JOSEPHINE
Entity Type:Individual
Prefix:
First Name:NGOZI
Middle Name:JOSEPHINE
Last Name:AZU
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 1:6072 S KALISPELL ST
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80016-4748
Mailing Address - Country:US
Mailing Address - Phone:720-272-8548
Mailing Address - Fax:
Practice Address - Street 1:7150 LEETSDALE DR
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80224-1999
Practice Address - Country:US
Practice Address - Phone:303-333-2035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-10
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO15738183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist