Provider Demographics
NPI:1942647557
Name:ONYEACHONAM, JOHN NNAMDI (RPH)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:NNAMDI
Last Name:ONYEACHONAM
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 1:1264 BENNING RD
Mailing Address - Street 2:
Mailing Address - City:CAPITOL HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20743-5173
Mailing Address - Country:US
Mailing Address - Phone:301-793-4538
Mailing Address - Fax:
Practice Address - Street 1:1264 BENNING RD
Practice Address - Street 2:
Practice Address - City:CAPITOL HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20743-5173
Practice Address - Country:US
Practice Address - Phone:301-793-4538
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-23
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18512183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist