Provider Demographics
NPI:1467905026
Name:ENYINNAYA, AMARACHI (PHARMD)
Entity Type:Individual
Prefix:
First Name:AMARACHI
Middle Name:
Last Name:ENYINNAYA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:AMARACHI
Other - Middle Name:
Other - Last Name:OTUWA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:301 CRESCENDO DR
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-5724
Mailing Address - Country:US
Mailing Address - Phone:708-465-6143
Mailing Address - Fax:
Practice Address - Street 1:301 CRESCENDO DR
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-5724
Practice Address - Country:US
Practice Address - Phone:708-465-6143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-01
Last Update Date:2016-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC230171835P0018X
IN26024191A1835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care