Provider Demographics
NPI:1659706729
Name:OVIAWE, UYIOSA (PHARM D)
Entity Type:Individual
Prefix:
First Name:UYIOSA
Middle Name:
Last Name:OVIAWE
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 1:8839 CRENSHAW DR
Mailing Address - Street 2:
Mailing Address - City:GROVETOWN
Mailing Address - State:GA
Mailing Address - Zip Code:30813-8326
Mailing Address - Country:US
Mailing Address - Phone:832-661-5342
Mailing Address - Fax:
Practice Address - Street 1:3228 WRIGHTSBORO RD
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-2937
Practice Address - Country:US
Practice Address - Phone:706-733-3715
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-09
Last Update Date:2013-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH027468183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist