Healthcare Provider Details

I. General information

NPI: 1841104551
Provider Name (Legal Business Name): GODFREY ODHIAMBO OCHIENG
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3A DIVISION PL
BENNINGTON VT
05201-1917
US

IV. Provider business mailing address

3A DIVISION PL
BENNINGTON VT
05201-1917
US

V. Phone/Fax

Practice location:
  • Phone: 682-816-9706
  • Fax:
Mailing address:
  • Phone: 682-816-9706
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number033.0136038
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: