Provider Demographics
NPI:1427186865
Name:OBIORA, IFEOMA (PHARMD)
Entity Type:Individual
Prefix:MISS
First Name:IFEOMA
Middle Name:
Last Name:OBIORA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4301 N 21ST ST UNIT 39
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-5575
Mailing Address - Country:US
Mailing Address - Phone:602-274-0553
Mailing Address - Fax:
Practice Address - Street 1:4301 N 21ST ST UNIT 39
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-5575
Practice Address - Country:US
Practice Address - Phone:602-274-0553
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ14487183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist