Provider Demographics
NPI:1689337644
Name:ZIMUCHA, BASIL KUDZAI (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BASIL
Middle Name:KUDZAI
Last Name:ZIMUCHA
Suffix:
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 1:6218 N BEULAH AVE
Mailing Address - Street 2:
Mailing Address - City:FERNDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98248-8022
Mailing Address - Country:US
Mailing Address - Phone:913-548-5253
Mailing Address - Fax:
Practice Address - Street 1:1070 E SUNSET DR
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-3509
Practice Address - Country:US
Practice Address - Phone:360-647-2713
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-18
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021034115183500000X
KS1-103678183500000X
WAPH61341288183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist