Provider Demographics
NPI:1255905030
Name:NGWA, RELINDIS SIRRI (RPH)
Entity type:Individual
Prefix:
First Name:RELINDIS
Middle Name:SIRRI
Last Name:NGWA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4412 SILVER TEAL RD
Mailing Address - Street 2:
Mailing Address - City:NOTTINGHAM
Mailing Address - State:MD
Mailing Address - Zip Code:21236-2963
Mailing Address - Country:US
Mailing Address - Phone:301-917-5037
Mailing Address - Fax:
Practice Address - Street 1:640 SUNBURST HWY
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21613-2546
Practice Address - Country:US
Practice Address - Phone:410-901-6290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-17
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD27895183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist