Provider Demographics
NPI:1437974920
Name:KOGE, NTUBE NGOMEKAME
Entity type:Individual
Prefix:
First Name:NTUBE
Middle Name:NGOMEKAME
Last Name:KOGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2550 E 88TH AVE
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-3814
Mailing Address - Country:US
Mailing Address - Phone:301-300-1474
Mailing Address - Fax:
Practice Address - Street 1:2550 E 88TH AVE
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-3814
Practice Address - Country:US
Practice Address - Phone:301-300-1474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-19
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK224700183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist