Provider Demographics
NPI:1336767441
Name:WOLO, MACARTHUR TUGBEH (RPH)
Entity Type:Individual
Prefix:
First Name:MACARTHUR
Middle Name:TUGBEH
Last Name:WOLO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:328 DOGWOOD ST
Mailing Address - Street 2:
Mailing Address - City:BROWNS MILLS
Mailing Address - State:NJ
Mailing Address - Zip Code:08015-1315
Mailing Address - Country:US
Mailing Address - Phone:609-836-3463
Mailing Address - Fax:
Practice Address - Street 1:2100 W CAMBRIA ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19132-2668
Practice Address - Country:US
Practice Address - Phone:609-836-3463
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-07
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP437304183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist