Provider Demographics
NPI:1780258145
Name:UGWUOKE, ABIOLA
Entity type:Individual
Prefix:
First Name:ABIOLA
Middle Name:
Last Name:UGWUOKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 MOUNT AIRE FARM RD
Mailing Address - Street 2:
Mailing Address - City:GLEN MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19342-3356
Mailing Address - Country:US
Mailing Address - Phone:267-210-8033
Mailing Address - Fax:215-447-8810
Practice Address - Street 1:3554 HULMEVILLE RD STE 108
Practice Address - Street 2:
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-4366
Practice Address - Country:US
Practice Address - Phone:267-332-2948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-19
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP440898183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist