Provider Demographics
NPI:1497438899
Name:ONYANGO, DANIEL AYIMBA (RPH)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:AYIMBA
Last Name:ONYANGO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 W DOVE VALLEY ROAD PHARMACY
Mailing Address - Street 2:PHARMACY
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85085-0013
Mailing Address - Country:US
Mailing Address - Phone:480-994-6235
Mailing Address - Fax:
Practice Address - Street 1:2800 W DOVE VALLEY ROAD PHARMACY
Practice Address - Street 2:PHARMACY
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85085-0013
Practice Address - Country:US
Practice Address - Phone:480-994-6235
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-11
Last Update Date:2023-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS026501183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist