Provider Demographics
NPI:1699843821
Name:TWEGBE, BLAMOH TEPLAH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BLAMOH
Middle Name:TEPLAH
Last Name:TWEGBE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 41ST ST
Mailing Address - Street 2:UNIT C
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-2689
Mailing Address - Country:US
Mailing Address - Phone:617-251-3876
Mailing Address - Fax:
Practice Address - Street 1:5729 COLLEGE AVENUE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94618
Practice Address - Country:US
Practice Address - Phone:510-740-1468
Practice Address - Fax:510-844-0483
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57488183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist