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General NPI Number Information
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NPI Number | 1942716550
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Entity Type | Organization
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Legal Business Name | KILIMANJARO PHARMACY, INC
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Dates
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Enumeration Date | 12/18/2017
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Last Update Date | 12/18/2017
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Provider Practice Location Address
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Address Line | 2345A HIGHWAY 46
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City | WASCO
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State | CA
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Zip | 93280-1167
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Country | US
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Telephone | 805-279-4886
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Fax |
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Provider Business Mailing Address
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Address Line | 2345A HIGHWAY 46
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City | WASCO
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State | CA
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Zip | 93280-1167
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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 | CEO/OWNER
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Name | OSMAN MUSSA
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Credential | PHARMACIST
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Telephone | 805-279-4886
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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