Provider Demographics
NPI:1326585068
Name:MUCHENE, PAUL KIARIE I (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:KIARIE
Last Name:MUCHENE
Suffix:I
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 1:1817 DALLAS NEBO RD
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30134-4865
Mailing Address - Country:US
Mailing Address - Phone:678-755-2631
Mailing Address - Fax:678-383-8715
Practice Address - Street 1:1817 DALLAS NEBO RD
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30134-4865
Practice Address - Country:US
Practice Address - Phone:678-383-8715
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-19
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH027404183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist