Provider Demographics
NPI:1215494935
Name:KIMANI, GICHUKI (PHARMD)
Entity type:Individual
Prefix:DR
First Name:GICHUKI
Middle Name:
Last Name:KIMANI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:869 N MAIN ST STE 203
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30009-8372
Mailing Address - Country:US
Mailing Address - Phone:470-275-6795
Mailing Address - Fax:
Practice Address - Street 1:869 N MAIN ST STE 203
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-8372
Practice Address - Country:US
Practice Address - Phone:470-275-6795
Practice Address - Fax:470-275-4962
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-28
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH021676183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist