Provider Demographics
NPI:1144057480
Name:EHIODO, PRECIOUS NDIDI NKEM (PHARMD)
Entity type:Individual
Prefix:
First Name:PRECIOUS
Middle Name:NDIDI NKEM
Last Name:EHIODO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:PRECIOUS
Other - Middle Name:NDIDI NKEM
Other - Last Name:OBINNA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:12224 DECLARATION AVE
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23836-3057
Mailing Address - Country:US
Mailing Address - Phone:804-939-8384
Mailing Address - Fax:
Practice Address - Street 1:2537 WEIR RD
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831-5351
Practice Address - Country:US
Practice Address - Phone:804-796-9886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-19
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202222299183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist