Provider Demographics
NPI:1750066437
Name:AKUJIEZE, AMARACHUKWU
Entity type:Individual
Prefix:
First Name:AMARACHUKWU
Middle Name:
Last Name:AKUJIEZE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 PHOENIX BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PARK
Mailing Address - State:GA
Mailing Address - Zip Code:30349-5595
Mailing Address - Country:US
Mailing Address - Phone:770-997-1112
Mailing Address - Fax:
Practice Address - Street 1:1720 PHOENIX BLVD STE 400
Practice Address - Street 2:
Practice Address - City:COLLEGE PARK
Practice Address - State:GA
Practice Address - Zip Code:30349-5595
Practice Address - Country:US
Practice Address - Phone:770-997-1112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-20
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH0335181835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist