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General NPI Number Information
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NPI Number | 1902714397
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Entity Type | Individual
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Provider Name | KABONGO BALUFU
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Gender | Male
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Dates
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Enumeration Date | 08/28/2026
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Last Update Date | 08/28/2026
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Provider Practice Location Address
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Address Line | 2680 N HIGH ST
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City | COLUMBUS
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State | OH
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Zip | 43202-1121
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Country | US
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Telephone | 614-267-5607
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Fax | 614-267-4536
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Provider Business Mailing Address
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Address Line | 5016 FARMHOUSE RD
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City | SOUTH BLOOMFIELD
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State | OH
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Zip | 43103-9250
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P2201X
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Taxonomy Name | Ambulatory Care Pharmacist
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License Number | 03445089
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License Number State | OH
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