Individual
ALICE NSHAMAMBA AGANZE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1010 E IRELAND RD, SOUTH BEND, IN 46614-2665
(574) 299-0154
Mailing address
5715 TOWN CENTER DR APT 10, GRANGER, IN 46530-4425
(773) 744-2389
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
26026996A
IN
183500000X
Pharmacist
Primary
5302046775
MI
Other
Enumeration date
06/18/2020
Last updated
06/18/2020
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