Provider Demographics
NPI:1295169498
Name:NGOKOBI, HARRIS (PHARMACIST)
Entity type:Individual
Prefix:DR
First Name:HARRIS
Middle Name:
Last Name:NGOKOBI
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 1:10407 DAMASCUS PARK LN
Mailing Address - Street 2:
Mailing Address - City:DAMASCUS
Mailing Address - State:MD
Mailing Address - Zip Code:20872-2734
Mailing Address - Country:US
Mailing Address - Phone:240-706-4507
Mailing Address - Fax:
Practice Address - Street 1:780 FAIRVIEW AVE APT 602
Practice Address - Street 2:
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-5952
Practice Address - Country:US
Practice Address - Phone:240-706-4507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-25
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC8987374U00000X
374U00000X
MD26043183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No374U00000XNursing Service Related ProvidersHome Health Aide