Provider Demographics
NPI:1427460468
Name:ENEMUOH, ALBERT CHUKWUNWIKE
Entity type:Individual
Prefix:
First Name:ALBERT
Middle Name:CHUKWUNWIKE
Last Name:ENEMUOH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8425 ELK GROVE FLORIN RD
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-9518
Mailing Address - Country:US
Mailing Address - Phone:916-681-5790
Mailing Address - Fax:916-681-5840
Practice Address - Street 1:8425 ELK GROVE FLORIN RD
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624-9518
Practice Address - Country:US
Practice Address - Phone:916-681-5790
Practice Address - Fax:916-681-5840
Is Sole Proprietor?:No
Enumeration Date:2014-05-26
Last Update Date:2014-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA67833183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist