Provider Demographics
NPI:1780239913
Name:ANAKWE CHARLES, GENEVIEVE NKIRUKA (PHARMD)
Entity type:Individual
Prefix:
First Name:GENEVIEVE
Middle Name:NKIRUKA
Last Name:ANAKWE CHARLES
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 1:1811 STONE MASON CT APT G
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-5581
Mailing Address - Country:US
Mailing Address - Phone:443-525-6763
Mailing Address - Fax:
Practice Address - Street 1:4389 BEAUFORT ROAD
Practice Address - Street 2:
Practice Address - City:HAVELOCK
Practice Address - State:NC
Practice Address - Zip Code:28532
Practice Address - Country:US
Practice Address - Phone:252-466-0921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-05
Last Update Date:2019-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC28289183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist