Provider Demographics
NPI:1780085944
Name:IWUEKE, CHIAMAKA (PHARM D)
Entity type:Individual
Prefix:
First Name:CHIAMAKA
Middle Name:
Last Name:IWUEKE
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 1:1169 UNION AVE APT 253
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-6675
Mailing Address - Country:US
Mailing Address - Phone:615-715-4979
Mailing Address - Fax:
Practice Address - Street 1:1201 GETWELL RD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38111-7315
Practice Address - Country:US
Practice Address - Phone:901-320-7135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-08
Last Update Date:2021-04-20
Deactivation Date:2018-07-24
Deactivation Code:
Reactivation Date:2021-04-20
Provider Licenses
StateLicense IDTaxonomies
TN38472183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist