Provider Demographics
NPI:1861254864
Name:KHAMISI, RAMADHANI HAJI (PHARMACIST)
Entity type:Individual
Prefix:
First Name:RAMADHANI
Middle Name:HAJI
Last Name:KHAMISI
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5514 CROYDEN ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67220-4024
Mailing Address - Country:US
Mailing Address - Phone:316-871-1266
Mailing Address - Fax:
Practice Address - Street 1:1330 N WOODLAWN ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67208-2647
Practice Address - Country:US
Practice Address - Phone:316-684-2828
Practice Address - Fax:316-684-4450
Is Sole Proprietor?:No
Enumeration Date:2024-01-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-109470183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist