Provider Demographics
NPI:1235742164
Name:MACHARIA, JOSEPHAT MWANGI (PHARMD)
Entity Type:Individual
Prefix:
First Name:JOSEPHAT
Middle Name:MWANGI
Last Name:MACHARIA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 N HWY 81
Mailing Address - Street 2:
Mailing Address - City:DUNCAN
Mailing Address - State:OK
Mailing Address - Zip Code:73533-1718
Mailing Address - Country:US
Mailing Address - Phone:941-284-5586
Mailing Address - Fax:
Practice Address - Street 1:1100 N HWY 81
Practice Address - Street 2:
Practice Address - City:DUNCAN
Practice Address - State:OK
Practice Address - Zip Code:73533-1794
Practice Address - Country:US
Practice Address - Phone:941-284-5586
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-29
Last Update Date:2020-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK18672183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist