Provider Demographics
NPI:1386227932
Name:AMAECHI, CHIGOZIRIM IHUOMA
Entity Type:Individual
Prefix:
First Name:CHIGOZIRIM
Middle Name:IHUOMA
Last Name:AMAECHI
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 1:583 JAMES ST
Mailing Address - Street 2:
Mailing Address - City:CHICOPEE
Mailing Address - State:MA
Mailing Address - Zip Code:01020-3911
Mailing Address - Country:US
Mailing Address - Phone:413-493-1860
Mailing Address - Fax:
Practice Address - Street 1:583 JAMES ST
Practice Address - Street 2:
Practice Address - City:CHICOPEE
Practice Address - State:MA
Practice Address - Zip Code:01020-3911
Practice Address - Country:US
Practice Address - Phone:413-493-1860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-02
Last Update Date:2021-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68435183500000X
MAPH239469183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist