Provider Demographics
NPI:1376998435
Name:OKAFOR, IKENNA STEPHEN (PHARMACIST)
Entity Type:Individual
Prefix:DR
First Name:IKENNA
Middle Name:STEPHEN
Last Name:OKAFOR
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 1:1585 BRIARFIELD RD APT 35
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-4846
Mailing Address - Country:US
Mailing Address - Phone:937-270-5905
Mailing Address - Fax:
Practice Address - Street 1:1585 BRIARFIELD RD APT 35
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-4846
Practice Address - Country:US
Practice Address - Phone:937-270-5905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-26
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202214580183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist