Provider Demographics
NPI:1740606573
Name:MAGUMA, HERCULES TARAMBIRWA (RPH)
Entity Type:Individual
Prefix:
First Name:HERCULES
Middle Name:TARAMBIRWA
Last Name:MAGUMA
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 1:1002 N SPENCE AVE
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-4270
Mailing Address - Country:US
Mailing Address - Phone:919-778-3238
Mailing Address - Fax:919-778-3442
Practice Address - Street 1:1002 N SPENCE AVE
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-4270
Practice Address - Country:US
Practice Address - Phone:919-778-3238
Practice Address - Fax:919-778-3442
Is Sole Proprietor?:No
Enumeration Date:2014-03-18
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20236183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist