Provider Demographics
NPI:1427716471
Name:NANGUE, THIERRY JOEL (RPH)
Entity type:Individual
Prefix:
First Name:THIERRY
Middle Name:JOEL
Last Name:NANGUE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2007 BROOKPARK RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44109-5813
Mailing Address - Country:US
Mailing Address - Phone:216-351-2944
Mailing Address - Fax:
Practice Address - Street 1:2007 BROOKPARK RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44109-5813
Practice Address - Country:US
Practice Address - Phone:216-351-2944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-07
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03441400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist