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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. PRYDE MANGA FONBAH, RPH

Deactivated Sole Proprietor

MR. PRYDE MANGA FONBAH, RPH is a Pharmacist healthcare provider located in UKIAH, California. NPI 1922239623 is deactivated in the NPPES registry. Verify at CMS.

Pharmacist · UKIAH, CA

This NPI has been deactivated. The record was deactivated on November 18, 2014. Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated. Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.

Registration Details

NPI Number
1922239623
Provider Type
Individual
Gender
Male
NPI Issued
Jul 29, 2009 (5.3068493150685 yrs)
Last Updated
Feb 23, 2016
Deactivated
Nov 18, 2014
License
47835 (CA)
Sole Proprietor
Yes

Practice Information

Address
155 S. ORCHARD AVE
UKIAH, CA, 95182
Browse CA providers · Browse ZIP 95182
Phone
7074629751
Primary Specialty
Pharmacist
183500000X

Other Pharmacist Providers in UKIAH, CA

Name Credential NPI
SUSAN ANN REED RPH 1730266412
GARY WAKEMAN RPH 1144390071
ERYN WHITAKER PHARMD 1447562624
DR. MARTHA S MAZUR-LANE PHARM D. 1497069264
MS. TAMMY TAM YAU RPH 1013215920
MR. KISOO OH PHARM D 1144510199
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.