Provider Demographics
NPI:1023789526
Name:OKEKE, MAGGIE C (RPH)
Entity type:Individual
Prefix:
First Name:MAGGIE
Middle Name:C
Last Name:OKEKE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:MAGDALEN
Other - Middle Name:C
Other - Last Name:OKEKE-EKPE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:2660 BUENA VISTA RD STE A
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31906-3914
Mailing Address - Country:US
Mailing Address - Phone:706-596-8871
Mailing Address - Fax:
Practice Address - Street 1:2660 BUENA VISTA RD STE A
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31906-3914
Practice Address - Country:US
Practice Address - Phone:706-596-8871
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-23
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH017026183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist