Provider Demographics
NPI:1750738639
Name:OFOKANSI, RENISE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:RENISE
Middle Name:
Last Name:OFOKANSI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 CAROLINA AVE
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02905-5402
Mailing Address - Country:US
Mailing Address - Phone:401-868-0277
Mailing Address - Fax:
Practice Address - Street 1:90 QUAKER LN
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-0111
Practice Address - Country:US
Practice Address - Phone:401-821-1802
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-19
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRPH05547183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist