Provider Demographics
NPI:1972841567
Name:NGUNJOH, FRU (PHARMACIST)
Entity Type:Individual
Prefix:DR
First Name:FRU
Middle Name:
Last Name:NGUNJOH
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20901 KELLY PL
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80249-6971
Mailing Address - Country:US
Mailing Address - Phone:303-993-4053
Mailing Address - Fax:
Practice Address - Street 1:20901 E SMOKY HILL RD
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80015-5184
Practice Address - Country:US
Practice Address - Phone:303-400-0627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-16
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO195431835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist