Provider Demographics
NPI:1740593409
Name:OSA-IYARE, SYLVESTER A (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SYLVESTER
Middle Name:A
Last Name:OSA-IYARE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22402 BELLAIRE BLVD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-3903
Mailing Address - Country:US
Mailing Address - Phone:281-202-0345
Mailing Address - Fax:
Practice Address - Street 1:220 US ROUTE 1 STE 1
Practice Address - Street 2:RITE AID PHARMACY
Practice Address - City:BUCKSPORT
Practice Address - State:ME
Practice Address - Zip Code:04416
Practice Address - Country:US
Practice Address - Phone:207-469-2201
Practice Address - Fax:207-469-6803
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-22
Last Update Date:2020-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPR5744183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist