Provider Demographics
NPI:1740895226
Name:NSOFOR, CHINWE C (PHARM D)
Entity type:Individual
Prefix:
First Name:CHINWE
Middle Name:C
Last Name:NSOFOR
Suffix:
Gender:F
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 1:139 MAYFIELD DR
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:GA
Mailing Address - Zip Code:31763-4973
Mailing Address - Country:US
Mailing Address - Phone:404-246-3857
Mailing Address - Fax:
Practice Address - Street 1:2414 SYLVESTER HWY
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31705-2469
Practice Address - Country:US
Practice Address - Phone:229-430-9119
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-11
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARHP030324183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist