Provider Demographics
NPI:1447518253
Name:IHEANACHO, NONYE I (PHARM D, RPH)
Entity type:Individual
Prefix:DR
First Name:NONYE
Middle Name:I
Last Name:IHEANACHO
Suffix:
Gender:M
Credentials:PHARM D, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10790 TOWN CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:DUNKIRK
Mailing Address - State:MD
Mailing Address - Zip Code:20754-2736
Mailing Address - Country:US
Mailing Address - Phone:410-286-2901
Mailing Address - Fax:
Practice Address - Street 1:10790 TOWN CENTER BLVD
Practice Address - Street 2:
Practice Address - City:DUNKIRK
Practice Address - State:MD
Practice Address - Zip Code:20754-2736
Practice Address - Country:US
Practice Address - Phone:410-286-2901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-30
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD26814183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist