Provider Demographics
NPI:1457776056
Name:OKORAFOR, NWAMMIRI (B PHARM)
Entity Type:Individual
Prefix:
First Name:NWAMMIRI
Middle Name:
Last Name:OKORAFOR
Suffix:
Gender:M
Credentials:B PHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 OAKWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:MELVINDALE
Mailing Address - State:MI
Mailing Address - Zip Code:48122-1150
Mailing Address - Country:US
Mailing Address - Phone:313-382-3996
Mailing Address - Fax:313-382-3989
Practice Address - Street 1:3600 OAKWOOD BLVD
Practice Address - Street 2:
Practice Address - City:MELVINDALE
Practice Address - State:MI
Practice Address - Zip Code:48122-1150
Practice Address - Country:US
Practice Address - Phone:313-382-3996
Practice Address - Fax:313-382-3989
Is Sole Proprietor?:No
Enumeration Date:2014-02-19
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302037956183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist