Provider Demographics
NPI:1922432103
Name:OKEKE, VICTORIA N (RPH)
Entity Type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:N
Last Name:OKEKE
Suffix:
Gender:F
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:BLUE HILL PHARMACY
Mailing Address - Street 2:320 BLUE HILL AVE.
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02121-1951
Mailing Address - Country:US
Mailing Address - Phone:617-652-7546
Mailing Address - Fax:617-652-7561
Practice Address - Street 1:320 BLUE HILL AVE
Practice Address - Street 2:PHARMACY DEPT
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02121-1951
Practice Address - Country:US
Practice Address - Phone:617-652-7092
Practice Address - Fax:617-652-7561
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-24
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH25059183500000X
MA25059183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110102251AMedicaid