Active NPI
Mond U Igbinowanhia
- Pharmacist
- Mableton, GA
National Provider Identifier
1881974376
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH018602
- Practice address
- 855 Veterans Memorial Hwy SE
Mableton, GA 30126-2733 - Phone
- (770) 819-7869
- NPI assigned
- Aug 28, 2011
- Last updated
- Aug 28, 2011
- Sex
- Male
- 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 | RPH018602 | GA | Primary |
Addresses
Primary practice location
855 Veterans Memorial Hwy SE
Mableton, GA 30126-2733
Mailing address
4564 Glore Crossing Dr SW
Mableton, GA 30126-5551
Phone (404) 402-0073
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH018602 | GA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1314489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314489600000",
"number": "1881974376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4564 GLORE CROSSING DR SW",
"city": "MABLETON",
"state": "GA",
"postal_code": "301265551",
"telephone_number": "404-402-0073"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "855 VETERANS MEMORIAL HWY SE",
"city": "MABLETON",
"state": "GA",
"postal_code": "301262733",
"telephone_number": "770-819-7869"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IGBINOWANHIA",
"first_name": "MOND",
"middle_name": "U",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-08-28",
"last_updated": "2011-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH018602",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mableton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.