Active NPI
Henrietta Chibugo Obialo-Nzerue
- Pharmacist
- Conyers, GA
National Provider Identifier
1326346693
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH020884
- Practice address
- 2240 Salem Rd SE
Conyers, GA 30013-1843 - Phone
- (770) 929-8711
- Fax
- (770) 483-7516
- NPI assigned
- Mar 10, 2011
- 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 | RPH020884 | GA | Primary |
Addresses
Primary practice location
2240 Salem Rd SE
Conyers, GA 30013-1843
Mailing address
2240 Salem Road,South East
Conyers, GA 30013
Phone (770) 929-8711
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
| License | State | Type | Specialty |
|---|---|---|---|
| RPH020884 | GA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1299715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1299715200000",
"number": "1326346693",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2240 SALEM ROAD,SOUTH EAST",
"city": "CONYERS",
"state": "GA",
"postal_code": "30013",
"telephone_number": "770-929-8711",
"fax_number": "770-483-7516"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2240 SALEM RD SE",
"city": "CONYERS",
"state": "GA",
"postal_code": "300131843",
"telephone_number": "770-929-8711",
"fax_number": "770-483-7516"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OBIALO-NZERUE",
"first_name": "HENRIETTA",
"middle_name": "CHIBUGO",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-03-10",
"last_updated": "2011-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH020884",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Conyers, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.