Individual provider Active NPI

Charles U Nwachukwu

  • Pharmacist
  • Ellicott City, MD
National Provider Identifier
1114448024
Registry record updated Jun 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
24715 Issued in MD
Practice address
4390 Montgomery Rd
Ellicott City, MD 21043-6068
Phone
(410) 203-1171
NPI assigned
Jun 30, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 24715 MD Primary

Addresses

Primary practice location

4390 Montgomery Rd
Ellicott City, MD 21043-6068

Mailing address

9916 Chessington Way
Bowie, MD 20721-2986
Phone (301) 768-7010

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

State licenses

LicenseStateTypeSpecialty
24715MDMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1498780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498780800000",
    "number": "1114448024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9916 CHESSINGTON WAY",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207212986",
            "telephone_number": "301-768-7010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4390 MONTGOMERY RD",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210436068",
            "telephone_number": "410-203-1171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWACHUKWU",
        "first_name": "CHARLES",
        "middle_name": "U",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-30",
        "last_updated": "2017-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "24715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.