Ehiozogie N Asemota, PHARMD, RPH

Individual provider Active NPI Pharmacist · Tucker, GA

NPI 1972194504 · NPPES record last updated Jan 27, 2021

Key facts

NPI
1972194504
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
RPH032611 (GA)
Practice address
4317 Chamblee Tucker Rd
Tucker, GA 30084-2106
Phone
(770) 938-6146
NPI assigned
Jan 27, 2021
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Pharmacy, Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
RPH032611GAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia CVS Pharmacy L.L.C Past
since Jan 31, 2021
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist
Group: 193400000X SINGLE SPECIALTY GROUP
183500000X RPH032611 GA Yes

Addresses

Primary practice location

4317 Chamblee Tucker Rd
Tucker, GA 30084-2106

Mailing address

4317 Chamblee Tucker Rd
Tucker, GA 30084-2106
Phone (770) 938-6146

Other providers in Tucker, GA

All providers in Tucker, GA · Pharmacist in Georgia

Sources for this page

Verify at the official NPI Registry.