Provider Demographics
NPI:1679874192
Name:OBOH, ONOVUGHODE TEGA (PHARMD)
Entity Type:Individual
Prefix:
First Name:ONOVUGHODE
Middle Name:TEGA
Last Name:OBOH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:ONO
Other - Middle Name:
Other - Last Name:OBOH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:2929 OLD FRANKLIN RD
Mailing Address - Street 2:APT 911
Mailing Address - City:ANTIOCH
Mailing Address - State:TN
Mailing Address - Zip Code:37013-3198
Mailing Address - Country:US
Mailing Address - Phone:404-704-0781
Mailing Address - Fax:
Practice Address - Street 1:2806 SMITH SPRINGS RD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37217-4311
Practice Address - Country:US
Practice Address - Phone:615-361-0182
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-15
Last Update Date:2010-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN34525183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist