Provider Demographics
NPI:1174048128
Name:AGBOR-ENOH, JUULCURLEY (PHARM D)
Entity type:Individual
Prefix:
First Name:JUULCURLEY
Middle Name:
Last Name:AGBOR-ENOH
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6509 RICE CT
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-5953
Mailing Address - Country:US
Mailing Address - Phone:1703-677-4629
Mailing Address - Fax:
Practice Address - Street 1:7400 RITCHIE HWY
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-3110
Practice Address - Country:US
Practice Address - Phone:410-760-2112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-11
Last Update Date:2017-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD24539183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0000000OtherNONE
NONEOtherNONE