Provider Demographics
NPI:1508072919
Name:AHILIGWO, OKWUDILI B (BPHARM)
Entity Type:Individual
Prefix:
First Name:OKWUDILI
Middle Name:B
Last Name:AHILIGWO
Suffix:
Gender:M
Credentials:BPHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:976 ELLENE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-1320
Mailing Address - Country:US
Mailing Address - Phone:530-828-6635
Mailing Address - Fax:
Practice Address - Street 1:220 W EAST AVE
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-7215
Practice Address - Country:US
Practice Address - Phone:530-343-9495
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48687183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist