Provider Demographics
NPI:1356500904
Name:ACHEAMPONG, YAW O (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:YAW
Middle Name:O
Last Name:ACHEAMPONG
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:624 WHISPER WOODS DR
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-5645
Mailing Address - Country:US
Mailing Address - Phone:863-607-4276
Mailing Address - Fax:863-607-4276
Practice Address - Street 1:311 E MEMORIAL BLVD
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33801-1766
Practice Address - Country:US
Practice Address - Phone:863-688-1386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-07
Last Update Date:2008-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS35155183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist