Provider Demographics
NPI:1497975437
Name:OKADIS PHARMACY CARE CLINIC &CONSULTING
Entity Type:Organization
Organization Name:OKADIS PHARMACY CARE CLINIC &CONSULTING
Other - Org Name:PHARMACIST-MEDICATION THERAPY MANAGEMENT GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO AND FOUNDER
Authorized Official - Prefix:DR
Authorized Official - First Name:CYRIL
Authorized Official - Middle Name:JIDE
Authorized Official - Last Name:OKADIGWE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:864-244-1570
Mailing Address - Street 1:PO BOX 5167
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29606-5167
Mailing Address - Country:US
Mailing Address - Phone:864-244-1570
Mailing Address - Fax:864-244-1560
Practice Address - Street 1:209 ALLIUM WAY
Practice Address - Street 2:
Practice Address - City:TAYLORS
Practice Address - State:SC
Practice Address - Zip Code:29687-5461
Practice Address - Country:US
Practice Address - Phone:864-244-1570
Practice Address - Fax:864-244-1560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC008738251B00000X, 251E00000X, 305S00000X, 313M00000X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251B00000XAgenciesCase Management
Not Answered251E00000XAgenciesHome Health
Not Answered305S00000XManaged Care OrganizationsPoint of Service
Not Answered313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Not Answered314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility