Provider Demographics
NPI:1174812663
Name:NJUBIGBO, NKECHI JENNIFER (RPH)
Entity type:Individual
Prefix:
First Name:NKECHI
Middle Name:JENNIFER
Last Name:NJUBIGBO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 BRADLEY CIR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-7943
Mailing Address - Country:US
Mailing Address - Phone:302-376-9152
Mailing Address - Fax:
Practice Address - Street 1:455 W MAIN ST
Practice Address - Street 2:( RITEAID PHARMACY)
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-1064
Practice Address - Country:US
Practice Address - Phone:302-376-7833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-05
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA10002567183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEA10002567OtherPHARMACIST LICENSE