Provider Demographics
NPI:1861779597
Name:ENTSUA-MENSAH, ALESHA COATES (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ALESHA
Middle Name:COATES
Last Name:ENTSUA-MENSAH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:ALESHA
Other - Middle Name:ESHEA
Other - Last Name:COATES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:3300 WESTERN PKWY
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20603-4582
Mailing Address - Country:US
Mailing Address - Phone:301-645-7580
Mailing Address - Fax:301-645-7580
Practice Address - Street 1:3300 WESTERN PKWY
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20603-4582
Practice Address - Country:US
Practice Address - Phone:301-645-7580
Practice Address - Fax:301-645-7580
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-09
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD17341183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist