Evelyn Omozusi Abhulimen, DR – Pharmacist

Key facts

NPI: 1366044299
Entity type: Individual (NPI type 1)
Primary specialty: Pharmacist 183500000X
License: PD11406 (AR)
Practice address: 133 Arkansas Blvd
Texarkana, AR 71854-1963
Phone: (870) 773-7872
NPI assigned: Nov 16, 2020
Sex: Female
Sole proprietor: Yes

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
PD11406	AR	MD	Pharmacist

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Pharmacist	183500000X	PD11406	AR	Yes

Addresses

Primary practice location

133 Arkansas Blvd
Texarkana, AR 71854-1963

Mailing address

29 Tulip Dr
Texarkana, TX 75503-2257
Phone (501) 246-0394

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 16, 2020.

{
    "created_epoch": "1605484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605484800000",
    "number": "1366044299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 TULIP DR",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755032257",
            "telephone_number": "501-246-0394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 ARKANSAS BLVD",
            "city": "TEXARKANA",
            "state": "AR",
            "postal_code": "718541963",
            "telephone_number": "870-773-7872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABHULIMEN",
        "first_name": "EVELYN",
        "middle_name": "OMOZUSI",
        "credential": "DR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-16",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AR",
            "license": "PD11406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Texarkana, AR

All providers in Texarkana, AR · Pharmacist in Arkansas

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 16, 2020. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.