Active NPI
Laza Mbundu Ndombe, RPH
- Pharmacist
- Manchester, NH
National Provider Identifier
1619252855
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 3045
- Practice address
- 1 Willow Street
Manchester, NH 03103 - Phone
- (603) 623-5773
- Fax
- (603) 623-7223
- NPI assigned
- Oct 19, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 3045 | NH | Primary |
Addresses
Primary practice location
1 Willow Street
Manchester, NH 03103
Mailing address
145 Aladdin Street
Manchester, NH 03104
Phone (603) 232-4880
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3045 | NH | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Maxi Drug North Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Laconia, NH
- NPI 1275632556
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1318982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318982400000",
"number": "1619252855",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "145 ALADDIN STREET",
"city": "MANCHESTER",
"state": "NH",
"postal_code": "03104",
"telephone_number": "603-232-4880",
"fax_number": "603-623-7223"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 WILLOW STREET",
"city": "MANCHESTER",
"state": "NH",
"postal_code": "03103",
"telephone_number": "603-623-5773",
"fax_number": "603-623-7223"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NDOMBE",
"first_name": "LAZA",
"middle_name": "MBUNDU",
"name_prefix": "Ms.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-10-19",
"last_updated": "2011-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NH",
"license": "3045",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manchester, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.