Provider Demographics
NPI:1780886630
Name:ABUJAME, AMANI MOHAMMED (PHARMACIST)
Entity type:Individual
Prefix:
First Name:AMANI
Middle Name:MOHAMMED
Last Name:ABUJAME
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4644 NW CHENILLE PL
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330-3196
Mailing Address - Country:US
Mailing Address - Phone:541-928-8668
Mailing Address - Fax:541-926-9462
Practice Address - Street 1:4644 NW CHENILLE PL
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-3196
Practice Address - Country:US
Practice Address - Phone:541-752-9036
Practice Address - Fax:541-926-9468
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR9699183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist