Provider Demographics
NPI:1427330190
Name:MACHUNGA, GODIYA (RPH)
Entity type:Individual
Prefix:MRS
First Name:GODIYA
Middle Name:
Last Name:MACHUNGA
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 1:12 QUARRY LN
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265-2775
Mailing Address - Country:US
Mailing Address - Phone:770-573-7245
Mailing Address - Fax:
Practice Address - Street 1:1 FARMER INDUSTRIAL BLVD
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30263-1078
Practice Address - Country:US
Practice Address - Phone:770-251-6778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-19
Last Update Date:2011-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH023464183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist