Provider Demographics
NPI:1457693145
Name:NWACHUKWU, WINIFRED CHINYERE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:WINIFRED
Middle Name:CHINYERE
Last Name:NWACHUKWU
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MRS
Other - First Name:WINIFRED
Other - Middle Name:CHINYERE
Other - Last Name:OBI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:16402 EDDINGER RD
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-6329
Mailing Address - Country:US
Mailing Address - Phone:240-755-7930
Mailing Address - Fax:301-702-6118
Practice Address - Street 1:6104 OLD BRANCH AVE
Practice Address - Street 2:
Practice Address - City:TEMPLE HILLS
Practice Address - State:MD
Practice Address - Zip Code:20748-2518
Practice Address - Country:US
Practice Address - Phone:301-702-6132
Practice Address - Fax:301-702-6118
Is Sole Proprietor?:No
Enumeration Date:2013-03-21
Last Update Date:2013-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12277183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist