Provider Demographics
NPI:1447988704
Name:MACUGA, RHONDA
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:
Last Name:MACUGA
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 1:13150 CHELSEA CT
Mailing Address - Street 2:
Mailing Address - City:GRAFTON
Mailing Address - State:OH
Mailing Address - Zip Code:44044-1082
Mailing Address - Country:US
Mailing Address - Phone:440-308-9795
Mailing Address - Fax:
Practice Address - Street 1:13150 CHELSEA CT
Practice Address - Street 2:
Practice Address - City:GRAFTON
Practice Address - State:OH
Practice Address - Zip Code:44044-1082
Practice Address - Country:US
Practice Address - Phone:440-308-9795
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-12
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03335235183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist