Provider Demographics
NPI:1386050276
Name:NDENGA, NOAH TUMUSIIME (PHARMD)
Entity type:Individual
Prefix:
First Name:NOAH
Middle Name:TUMUSIIME
Last Name:NDENGA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8699 PINE ISLAND CT S
Mailing Address - Street 2:
Mailing Address - City:MATTAWAN
Mailing Address - State:MI
Mailing Address - Zip Code:49071-9560
Mailing Address - Country:US
Mailing Address - Phone:269-271-1676
Mailing Address - Fax:
Practice Address - Street 1:8699 PINE ISLAND CT S
Practice Address - Street 2:
Practice Address - City:MATTAWAN
Practice Address - State:MI
Practice Address - Zip Code:49071-9560
Practice Address - Country:US
Practice Address - Phone:269-271-1676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-11
Last Update Date:2014-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302037264183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist