Provider Demographics
NPI:1831794304
Name:MANU, PATRICK OPPONG (PHARMD)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:OPPONG
Last Name:MANU
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 GRANBY RD APT 1
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01604-1645
Mailing Address - Country:US
Mailing Address - Phone:774-641-2934
Mailing Address - Fax:
Practice Address - Street 1:521 LINCOLN STREET
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-0160
Practice Address - Country:US
Practice Address - Phone:508-852-5790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-02
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH239764183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist