Basic Information
| Provider Information | |||||||||
| NPI: | 1407369077 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | AMPOMAAH | ||||||||
| FirstName: | WINIFRED | ||||||||
| MiddleName: | AGYEI | ||||||||
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| Credential: | PHARMD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1020 S MESA HILLS DR APT 4903 | ||||||||
| Address2: | |||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 799125119 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6468125821 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 101 E REDD ROAD | ||||||||
| Address2: | |||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 79931 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9152066140 | ||||||||
| FaxNumber: | 9152066141 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/06/2017 | ||||||||
| LastUpdateDate: | 11/06/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 59912 | TX | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.