Active NPI
Ijeoma Lorraine Odigwe, PHARM.D
- Pharmacist
- Pueblo of Acoma, NM
National Provider Identifier
1063898807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0202213884
- Practice address
- 80B Veterans Blvd
Pueblo of Acoma, NM 87034 - Phone
- (505) 552-5812
- Fax
- (505) 552-5464
- NPI assigned
- Aug 4, 2015
- Last updated
- Feb 7, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0202213884 | VA | Primary |
Addresses
Primary practice location
80B Veterans Blvd
Pueblo of Acoma, NM 87034
Mailing address
PO Box 278
San Fidel, NM 87049-0278
Phone (301) 752-9505
Other practice location 1
2204 Mount Vernon Ave
Alexandria, VA 22301-1362
Phone (703) 836-1700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0202213884 | VA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Neighborhood Pharmacies Inc | Past | Accepting new patients | |
| Neighborhood Pharmacies Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Home Pack by Neighborhood Pharmacy
- Long Term Care Pharmacy
- Alexandria, VA
- NPI 1063068864
-
dba Neighborhood Pharmacy of Del Ray
- Community/Retail Pharmacy
- Alexandria, VA
- NPI 1538308838
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1438646400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549497600000",
"number": "1063898807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 278",
"city": "SAN FIDEL",
"state": "NM",
"postal_code": "870490278",
"telephone_number": "301-752-9505"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "80B VETERANS BLVD",
"city": "PUEBLO OF ACOMA",
"state": "NM",
"postal_code": "87034",
"telephone_number": "505-552-5812",
"fax_number": "505-552-5464"
}
],
"practiceLocations": [
{
"address_1": "2204 Mount Vernon Ave",
"address_purpose": "LOCATION",
"city": "Alexandria",
"state": "VA",
"postal_code": "223011362",
"country_code": "US",
"telephone_number": "703-836-1700",
"fax_number": "703-836-1701",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ODIGWE",
"first_name": "IJEOMA",
"middle_name": "LORRAINE",
"name_prefix": "Dr.",
"credential": "PHARM.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-08-04",
"last_updated": "2019-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202213884",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pueblo of Acoma, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.