Provider Demographics
NPI:1437753761
Name:OHAYA, VINCENT UZOMA
Entity Type:Individual
Prefix:
First Name:VINCENT
Middle Name:UZOMA
Last Name:OHAYA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1603 BRIDGE MILL DR SE APT I
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-3852
Mailing Address - Country:US
Mailing Address - Phone:678-663-0135
Mailing Address - Fax:
Practice Address - Street 1:2994 ATLANTA RD SE
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-3655
Practice Address - Country:US
Practice Address - Phone:770-435-2178
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-27
Last Update Date:2020-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA025937183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist