=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598192320
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | VIRGINIA KIMANI
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/13/2013
-----------------------------------------------------
Last Update Date | 10/13/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8194 CHARLOTTE WAY AVE 8194 CHAROTTE WAY AVE
-----------------------------------------------------
City | WESTERVILLE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43081-7500
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 614-806-0164
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8194 CHARLOTTE WAY AVE 8194 CHARLOTTE WAY AVE
-----------------------------------------------------
City | WESTERVILLE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43081-7500
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 614-806-0164
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CAREGIVER
-----------------------------------------------------
Name | MRS. VIRGINIA W KIMANI
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 614-806-0164
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 385H00000X
-----------------------------------------------------
Taxonomy Name | Respite Care
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------