Provider Demographics
NPI:1912300500
Name:NKRUMAH-ABROKWAH, MAXWELL (PHARMD)
Entity Type:Individual
Prefix:
First Name:MAXWELL
Middle Name:
Last Name:NKRUMAH-ABROKWAH
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 1:2200 1ST ST
Mailing Address - Street 2:APT. 605
Mailing Address - City:ALAMOGORDO
Mailing Address - State:NM
Mailing Address - Zip Code:88310-3400
Mailing Address - Country:US
Mailing Address - Phone:574-261-3354
Mailing Address - Fax:
Practice Address - Street 1:955 N WHITE SANDS BLVD
Practice Address - Street 2:
Practice Address - City:ALAMOGORDO
Practice Address - State:NM
Practice Address - Zip Code:88310-6925
Practice Address - Country:US
Practice Address - Phone:575-434-4116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-27
Last Update Date:2014-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00008258183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist