Provider Demographics
NPI:1174810097
Name:OKINE, CHARLES CECIL (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:CECIL
Last Name:OKINE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 KNIGHTSBRIDGE CT
Mailing Address - Street 2:APT#205
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-4647
Mailing Address - Country:US
Mailing Address - Phone:804-986-1441
Mailing Address - Fax:
Practice Address - Street 1:15341 MONTANUS DR
Practice Address - Street 2:TARGET 2250
Practice Address - City:CULPEPER
Practice Address - State:VA
Practice Address - Zip Code:22701
Practice Address - Country:US
Practice Address - Phone:540-828-6634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-29
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202207650183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist