Provider Demographics
NPI:1356610539
Name:AGBI, KELECHI EGWU (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KELECHI
Middle Name:EGWU
Last Name:AGBI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 BRIGHTSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-4806
Mailing Address - Country:US
Mailing Address - Phone:410-484-7595
Mailing Address - Fax:
Practice Address - Street 1:5657 BALTIMORE NATIONAL PIKE
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-1412
Practice Address - Country:US
Practice Address - Phone:410-788-1207
Practice Address - Fax:410-788-1964
Is Sole Proprietor?:No
Enumeration Date:2011-12-18
Last Update Date:2011-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15844183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist