Provider Demographics
NPI:1346909454
Name:DIGBEU, GNOLEBA G
Entity type:Individual
Prefix:
First Name:GNOLEBA
Middle Name:G
Last Name:DIGBEU
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 1:243 PLEASANT ST UNIT 42
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-2538
Mailing Address - Country:US
Mailing Address - Phone:508-488-8354
Mailing Address - Fax:
Practice Address - Street 1:92 SOUTH ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-2826
Practice Address - Country:US
Practice Address - Phone:508-488-8354
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-16
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHPHCY-01272183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist