Provider Demographics
NPI:1831354489
Name:OEI, IMAJANTI (REGISTEREDPHARMACIST)
Entity type:Individual
Prefix:
First Name:IMAJANTI
Middle Name:
Last Name:OEI
Suffix:
Gender:F
Credentials:REGISTEREDPHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16120 BEAR VALLEY ROAD
Mailing Address - Street 2:RITE AID PHARMACY
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92395
Mailing Address - Country:US
Mailing Address - Phone:760-951-0210
Mailing Address - Fax:760-951-0578
Practice Address - Street 1:16120 BEAR VALLEY ROAD
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395
Practice Address - Country:US
Practice Address - Phone:760-951-0210
Practice Address - Fax:760-951-0578
Is Sole Proprietor?:No
Enumeration Date:2008-07-23
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38273183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist