Provider Demographics
NPI:1902406770
Name:UMEJIAKU, GODWIN CHUKWUEMEKA (RPH)
Entity Type:Individual
Prefix:
First Name:GODWIN
Middle Name:CHUKWUEMEKA
Last Name:UMEJIAKU
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2569 SUNFLOWER LN
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77713-8202
Mailing Address - Country:US
Mailing Address - Phone:713-829-8183
Mailing Address - Fax:
Practice Address - Street 1:100 N LHS DR
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:TX
Practice Address - Zip Code:77657-8619
Practice Address - Country:US
Practice Address - Phone:409-755-2568
Practice Address - Fax:409-755-2412
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33590183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist