Provider Demographics
NPI:1942934880
Name:OJIBAH, BENEDICTA
Entity Type:Individual
Prefix:DR
First Name:BENEDICTA
Middle Name:
Last Name:OJIBAH
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 1:520 E WASHINGTON ST APT 249
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46204-0112
Mailing Address - Country:US
Mailing Address - Phone:708-299-7231
Mailing Address - Fax:
Practice Address - Street 1:4901 STATE ROAD 26 E
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47905-4611
Practice Address - Country:US
Practice Address - Phone:708-299-7231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-15
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26029492A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist