Provider Demographics
NPI:1437292349
Name:ADIGWEME, ALOY IKECHUKWU (RPH)
Entity Type:Individual
Prefix:DR
First Name:ALOY
Middle Name:IKECHUKWU
Last Name:ADIGWEME
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:PO BOX 43364
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32203-3364
Mailing Address - Country:US
Mailing Address - Phone:904-260-2792
Mailing Address - Fax:904-680-0695
Practice Address - Street 1:5134 FIRESTONE RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32210-6722
Practice Address - Country:US
Practice Address - Phone:904-777-9911
Practice Address - Fax:904-680-0695
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0020649183500000X, 1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered183500000XPharmacy Service ProvidersPharmacist
Not Answered1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy