Basic Information
| Provider Information | |||||||||
| NPI: | 1114257565 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OKOYE | ||||||||
| FirstName: | ISAAC | ||||||||
| MiddleName: | OKECHUKWU | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | R.PH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 19450 LORAIN RD | ||||||||
| Address2: | APT # 210W | ||||||||
| City: | FAIRVIEW PARK | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441261975 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4403561073 | ||||||||
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| Practice Location | |||||||||
| Address1: | PINON ROUTE 4 | ||||||||
| Address2: | AT PINON PHARMACY | ||||||||
| City: | PINON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 85610 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9287259500 | ||||||||
| FaxNumber: | 9287259542 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/07/2010 | ||||||||
| LastUpdateDate: | 01/07/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 03316871 | OH | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.