Provider Demographics
NPI:1558734053
Name:AKOSAH, AKWASI
Entity Type:Individual
Prefix:
First Name:AKWASI
Middle Name:
Last Name:AKOSAH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 CRESWELL LN
Mailing Address - Street 2:
Mailing Address - City:OPELOUSAS
Mailing Address - State:LA
Mailing Address - Zip Code:70570-5810
Mailing Address - Country:US
Mailing Address - Phone:337-942-4228
Mailing Address - Fax:
Practice Address - Street 1:410 CRESWELL LN
Practice Address - Street 2:
Practice Address - City:OPELOUSAS
Practice Address - State:LA
Practice Address - Zip Code:70570-5810
Practice Address - Country:US
Practice Address - Phone:337-942-4228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-05
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA021345183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist