Provider Demographics
NPI:1972021764
Name:OFILI, EMMANUEL CHIKE
Entity Type:Individual
Prefix:
First Name:EMMANUEL
Middle Name:CHIKE
Last Name:OFILI
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 1:16 LIBERTY PL APT 7
Mailing Address - Street 2:
Mailing Address - City:WINDSOR MILL
Mailing Address - State:MD
Mailing Address - Zip Code:21244-2542
Mailing Address - Country:US
Mailing Address - Phone:410-493-7013
Mailing Address - Fax:
Practice Address - Street 1:3400 MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:MD
Practice Address - Zip Code:21122-2021
Practice Address - Country:US
Practice Address - Phone:410-360-1509
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-01
Last Update Date:2017-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25246183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist