Provider Demographics
NPI:1386002004
Name:MENAKAYA, CHIDOZIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:CHIDOZIE
Middle Name:
Last Name:MENAKAYA
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 1:250 SAWTOOTH DR APT 7
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-4528
Mailing Address - Country:US
Mailing Address - Phone:774-232-1644
Mailing Address - Fax:
Practice Address - Street 1:1550 SKIBO RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-3478
Practice Address - Country:US
Practice Address - Phone:910-868-5242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-09
Last Update Date:2016-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC25677183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist