Provider Demographics
NPI:1780089920
Name:OKWU, DOZIE VALENTINE (RPH)
Entity type:Individual
Prefix:MR
First Name:DOZIE
Middle Name:VALENTINE
Last Name:OKWU
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19160 GREENFIELD ROAD
Mailing Address - Street 2:RITE AID PHARMACY
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48235
Mailing Address - Country:US
Mailing Address - Phone:313-862-2603
Mailing Address - Fax:
Practice Address - Street 1:19160 GREENFIELD ROAD
Practice Address - Street 2:RITE AID PHARMACY
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235
Practice Address - Country:US
Practice Address - Phone:313-862-2603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-30
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302042077183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist