Provider Demographics
NPI:1689379380
Name:EJINWA, TONY IKECHUKWU (PHARMACY TECH)
Entity Type:Individual
Prefix:MR
First Name:TONY
Middle Name:IKECHUKWU
Last Name:EJINWA
Suffix:
Gender:M
Credentials:PHARMACY TECH
Other - Prefix:
Other - First Name:TONY
Other - Middle Name:IKECHUKWU
Other - Last Name:EJINWA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARM TECH
Mailing Address - Street 1:4501 NEWS RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-7803
Mailing Address - Country:US
Mailing Address - Phone:757-220-1287
Mailing Address - Fax:757-220-9056
Practice Address - Street 1:4501 NEWS RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-7803
Practice Address - Country:US
Practice Address - Phone:757-220-1287
Practice Address - Fax:757-220-9056
Is Sole Proprietor?:No
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0230012532183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician