Chiyah Boma Ngehnevu, PHARMD
Individual provider Active NPI Pharmacist · Longview, TX
NPI 1497537625 · NPPES record last updated Oct 23, 2023
Key facts
- NPI
- 1497537625
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 73386 (TX)
- Practice address
- 1754 W Loop 281
Longview, TX 75604-2733 - Phone
- (903) 759-3816
- NPI assigned
- Oct 23, 2023
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 73386 | TX | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CVS Pharmacy Inc | Past |
Accepting new patients | |
| CVS Pharmacy Inc | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 73386 | TX | Yes |
Addresses
Primary practice location
1754 W Loop 281
Longview, TX 75604-2733
Mailing address
604 S Park St
Longview, TX 75601-7707
Other providers in Longview, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 23, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.