Provider Demographics
NPI:1205604238
Name:ABOAGYE, GLORIA KWATEMAH
Entity type:Individual
Prefix:
First Name:GLORIA
Middle Name:KWATEMAH
Last Name:ABOAGYE
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 1:748 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-9066
Mailing Address - Country:US
Mailing Address - Phone:614-865-0352
Mailing Address - Fax:
Practice Address - Street 1:748 N STATE ST
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-9066
Practice Address - Country:US
Practice Address - Phone:614-865-0352
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-19
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03443884183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist