Provider Demographics
NPI:1154858876
Name:MUCHIRI, SAMUEL KIMANI
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:KIMANI
Last Name:MUCHIRI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4387 RIDGEMONT CIR
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-2538
Mailing Address - Country:US
Mailing Address - Phone:205-370-3417
Mailing Address - Fax:
Practice Address - Street 1:4387 RIDGEMONT CIR
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-2538
Practice Address - Country:US
Practice Address - Phone:205-370-3417
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL16025104374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide