Provider Demographics
NPI:1518249408
Name:AGYEI, CHRISTIAN CLARENCE (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:CHRISTIAN
Middle Name:CLARENCE
Last Name:AGYEI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6632 ARROW HILL ST
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89084-2082
Mailing Address - Country:US
Mailing Address - Phone:702-430-9800
Mailing Address - Fax:702-430-9800
Practice Address - Street 1:6632 ARROW HILL ST
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89084-2082
Practice Address - Country:US
Practice Address - Phone:702-430-9800
Practice Address - Fax:702-430-9800
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-15
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 59474183500000X
TX45010183500000X
NV169741835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist