Provider Demographics
NPI:1629465018
Name:KIMSA HEALTH CARE INC.
Entity Type:Organization
Organization Name:KIMSA HEALTH CARE INC.
Other - Org Name:AVENUE H PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST-IN-CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:PRISCA
Authorized Official - Middle Name:EKEOMA
Authorized Official - Last Name:NWOSU
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:281-885-9829
Mailing Address - Street 1:3926 AVENUE H STE 2
Mailing Address - Street 2:
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77471-2842
Mailing Address - Country:US
Mailing Address - Phone:832-945-5611
Mailing Address - Fax:877-610-2820
Practice Address - Street 1:3926 AVENUE H STE 2
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471-2842
Practice Address - Country:US
Practice Address - Phone:832-945-5611
Practice Address - Fax:877-610-2820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-23
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX299573336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy