Provider Demographics
NPI:1366858714
Name:OSIOHWO, SILAS
Entity type:Individual
Prefix:
First Name:SILAS
Middle Name:
Last Name:OSIOHWO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 S MOUNT AUBURN RD
Mailing Address - Street 2:
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63703-6387
Mailing Address - Country:US
Mailing Address - Phone:573-686-4151
Mailing Address - Fax:573-778-9787
Practice Address - Street 1:711 S MOUNT AUBURN RD
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63703-6387
Practice Address - Country:US
Practice Address - Phone:573-686-4151
Practice Address - Fax:573-778-9787
Is Sole Proprietor?:No
Enumeration Date:2014-07-07
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA22236183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist