Organization Active NPI

Kilimanjaro Pharmacy, Inc

  • Community/Retail Pharmacy
  • Wasco, CA
National Provider Identifier
1942716550
Registry record updated Dec 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
KILIMANJARO PHARMACY, INC
Practice address
2345A Highway 46
Wasco, CA 93280-1167
Phone
(805) 279-4886
NPI assigned
Dec 18, 2017
Last updated
Dec 18, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Osman Mussa, PHARMACISTNPI 1346534823
Title
Ceo/Owner
Phone
(805) 279-4886

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X NU Primary

Addresses

Primary practice location

2345A Highway 46
Wasco, CA 93280-1167

Mailing address

2345A Highway 46
Wasco, CA 93280-1167

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190618003048 CA Part B Supplier - Pharmacy 7810221223 Practice locations: Wasco, CA

National Provider Directory

National Provider Directory

Locations

2345 Highway 46
#A
Wasco, CA 93280
Phone (805) 279-4886

2345 Highway 46
Ste A
Wasco, CA 93280
Phone (661) 240-5661

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1513555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513555200000",
    "number": "1942716550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2345A HIGHWAY 46",
            "city": "WASCO",
            "state": "CA",
            "postal_code": "932801167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2345A HIGHWAY 46",
            "city": "WASCO",
            "state": "CA",
            "postal_code": "932801167",
            "telephone_number": "805-279-4886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KILIMANJARO PHARMACY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-18",
        "last_updated": "2017-12-18",
        "status": "A",
        "authorized_official_last_name": "MUSSA",
        "authorized_official_first_name": "OSMAN",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "805-279-4886",
        "authorized_official_credential": "PHARMACIST"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wasco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.