Provider Demographics
NPI:1518463074
Name:OFOSUHENE, KWADWO KISSI (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KWADWO
Middle Name:KISSI
Last Name:OFOSUHENE
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 1:5602 GREENBLUFF RD APT 101
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40219-2499
Mailing Address - Country:US
Mailing Address - Phone:502-612-5056
Mailing Address - Fax:
Practice Address - Street 1:5602 GREENBLUFF RD APT 101
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40219-2499
Practice Address - Country:US
Practice Address - Phone:502-612-5056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-03
Last Update Date:2018-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY019760183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist