Provider Demographics
NPI:1538374061
Name:ONWUKA, CHUKWUDI L (RPH)
Entity type:Individual
Prefix:MR
First Name:CHUKWUDI
Middle Name:L
Last Name:ONWUKA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3776 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:GARY
Mailing Address - State:IN
Mailing Address - Zip Code:46408-2203
Mailing Address - Country:US
Mailing Address - Phone:219-884-4445
Mailing Address - Fax:219-884-4480
Practice Address - Street 1:3776 BROADWAY
Practice Address - Street 2:
Practice Address - City:GARY
Practice Address - State:IN
Practice Address - Zip Code:46408-2203
Practice Address - Country:US
Practice Address - Phone:219-884-4445
Practice Address - Fax:219-884-4480
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26015840A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist