Provider Demographics
NPI:1265714950
Name:IJEOMA, SUNDAY (PHARM D)
Entity type:Individual
Prefix:
First Name:SUNDAY
Middle Name:
Last Name:IJEOMA
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4120 AUSTELL RD
Mailing Address - Street 2:
Mailing Address - City:AUSTELL
Mailing Address - State:GA
Mailing Address - Zip Code:30106-1841
Mailing Address - Country:US
Mailing Address - Phone:770-941-2918
Mailing Address - Fax:770-941-5841
Practice Address - Street 1:4120 AUSTELL RD
Practice Address - Street 2:
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30106-1841
Practice Address - Country:US
Practice Address - Phone:770-941-2918
Practice Address - Fax:770-941-5841
Is Sole Proprietor?:No
Enumeration Date:2011-09-19
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH0161181835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist