Provider Demographics
NPI:1922397108
Name:MANU, ANNOR
Entity Type:Individual
Prefix:DR
First Name:ANNOR
Middle Name:
Last Name:MANU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 N MARKET ST
Mailing Address - Street 2:RITE AID PHARMACY
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19802-2215
Mailing Address - Country:US
Mailing Address - Phone:302-762-1127
Mailing Address - Fax:
Practice Address - Street 1:3801 N MARKET ST
Practice Address - Street 2:RITE AID PHARMACY
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19802-2215
Practice Address - Country:US
Practice Address - Phone:302-762-1127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-28
Last Update Date:2011-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0003419183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist