Provider Demographics
NPI:1871883751
Name:IWEBOR, HENRY UCHECHUKWUKA (RPH)
Entity type:Individual
Prefix:MR
First Name:HENRY
Middle Name:UCHECHUKWUKA
Last Name:IWEBOR
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 1:1721 E MANNING AVE
Mailing Address - Street 2:RITE AID PHARMACY
Mailing Address - City:REEDLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93654-9468
Mailing Address - Country:US
Mailing Address - Phone:559-638-6349
Mailing Address - Fax:
Practice Address - Street 1:1721 E MANNING AVENUE
Practice Address - Street 2:
Practice Address - City:REEDLEY
Practice Address - State:CA
Practice Address - Zip Code:93654
Practice Address - Country:US
Practice Address - Phone:559-638-6349
Practice Address - Fax:559-637-1523
Is Sole Proprietor?:No
Enumeration Date:2011-04-13
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH61174183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist