Provider Demographics
NPI:1942890983
Name:MEJANG EPSE CHE, LOVELINE NDIKUM AZEH
Entity Type:Individual
Prefix:
First Name:LOVELINE
Middle Name:NDIKUM AZEH
Last Name:MEJANG EPSE CHE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 ASHDALE CIR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-6917
Mailing Address - Country:US
Mailing Address - Phone:302-565-7646
Mailing Address - Fax:
Practice Address - Street 1:372 POSSUM PARK RD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-3851
Practice Address - Country:US
Practice Address - Phone:302-455-1707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-23
Last Update Date:2021-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA-0015599183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist