Provider Demographics
NPI:1508307356
Name:ELELE, OKECHUKWU (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:OKECHUKWU
Middle Name:
Last Name:ELELE
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40982 PIPITS LN
Mailing Address - Street 2:
Mailing Address - City:LEONARDTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20650-2246
Mailing Address - Country:US
Mailing Address - Phone:240-434-5577
Mailing Address - Fax:
Practice Address - Street 1:21676 GREAT MILLS RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON PARK
Practice Address - State:MD
Practice Address - Zip Code:20653-3806
Practice Address - Country:US
Practice Address - Phone:301-863-7462
Practice Address - Fax:301-863-5631
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-13
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22874183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist