1306275540 NPI number — DR. RAMONA ELIZABETH MAGAMBO PHARMD

Table of content: DR. RAMONA ELIZABETH MAGAMBO PHARMD (NPI 1306275540)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306275540 NPI number — DR. RAMONA ELIZABETH MAGAMBO PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MAGAMBO
Provider First Name:
RAMONA
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MAGAMBO
Provider Other First Name:
ELIZABETH
Provider Other Middle Name:
RAMONA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1306275540
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/07/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1675 W 18TH AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EUGENE
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97402-3814
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
541-485-0427
Provider Business Mailing Address Fax Number:
541-485-1484

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1675 W 18TH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EUGENE
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97402-3814
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-485-0427
Provider Business Practice Location Address Fax Number:
541-485-1484
Provider Enumeration Date:
11/07/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  0011340 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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