=====================================================
General NPI Number Information
=====================================================
NPI Number | 1649159021
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BIENFAITEUR MUGISHA PHARMD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/29/2025
-----------------------------------------------------
Last Update Date | 08/29/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 200 US HIGHWAY 70 E
-----------------------------------------------------
City | HILLSBOROUGH
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27278-7500
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 919-732-6263
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 580 HOMEMONT AVE
-----------------------------------------------------
City | HILLSBOROUGH
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27278-9636
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 984-244-4726
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 34185
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------