Individual
IKE OKOLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
620 W PIKE ST, LAWRENCEVILLE, GA 30046-7699
(770) 339-1801
Mailing address
11405 MABRYPARK PL, ALPHARETTA, GA 30022-7361
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH025337
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RPH025337
STATE LICENSE NUMBER
GA
Enumeration date
11/30/2020
Last updated
11/30/2020
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