Provider Demographics
NPI:1053611814
Name:OMENANKITI, ESTHER E (RPH)
Entity type:Individual
Prefix:MRS
First Name:ESTHER
Middle Name:E
Last Name:OMENANKITI
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 1:6300 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:SEAT PLEASANT
Mailing Address - State:MD
Mailing Address - Zip Code:20743-2163
Mailing Address - Country:US
Mailing Address - Phone:301-350-3502
Mailing Address - Fax:
Practice Address - Street 1:6300 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:SEAT PLEASANT
Practice Address - State:MD
Practice Address - Zip Code:20743-2163
Practice Address - Country:US
Practice Address - Phone:301-350-3502
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-27
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD13935183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist