Provider Demographics
NPI:1376099283
Name:AFRIYIE, VICTOR K (RPH)
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:K
Last Name:AFRIYIE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 S LONG BEACH BLVD
Mailing Address - Street 2:SUITE C
Mailing Address - City:COMPTON
Mailing Address - State:CA
Mailing Address - Zip Code:90221-3449
Mailing Address - Country:US
Mailing Address - Phone:310-639-1653
Mailing Address - Fax:
Practice Address - Street 1:403 S LONG BEACH BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:COMPTON
Practice Address - State:CA
Practice Address - Zip Code:90221-3449
Practice Address - Country:US
Practice Address - Phone:310-639-1653
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-31
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32936183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist