Provider Demographics
NPI:1790285088
Name:AHENKORAH, JOSEPH KWAME (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:KWAME
Last Name:AHENKORAH
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 1:1555 SELBY AVE APT 469
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-7248
Mailing Address - Country:US
Mailing Address - Phone:952-297-4165
Mailing Address - Fax:
Practice Address - Street 1:2099 FORD PKWY
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55116-1814
Practice Address - Country:US
Practice Address - Phone:651-414-3882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-13
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN125903183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist