Provider Demographics
NPI:1629348131
Name:OKEREKE, HENRY ODOEMELE (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:HENRY
Middle Name:ODOEMELE
Last Name:OKEREKE
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:DONALD
Other - Middle Name:
Other - Last Name:UDE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMACIST
Mailing Address - Street 1:7015 NARCOOSSEE RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-5531
Mailing Address - Country:US
Mailing Address - Phone:407-380-9569
Mailing Address - Fax:407-380-9466
Practice Address - Street 1:7015 NARCOOSSEE RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-5531
Practice Address - Country:US
Practice Address - Phone:407-380-9569
Practice Address - Fax:407-380-9466
Is Sole Proprietor?:No
Enumeration Date:2012-01-01
Last Update Date:2012-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS38663183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist