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Individual

DR. KENNEDY KAMBO WAINAINA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARM D

Contact information

Practice address
10477 W FAIRVIEW AVE, BOISE, ID 83704-8008
(208) 377-5153
Mailing address
2937 S BAY STAR WAY, MERIDIAN, ID 83642-3094
(208) 440-3512

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
0010516
OR
183500000X
Pharmacist
Primary
P5825
ID

Other

Enumeration date
05/23/2013
Last updated
05/23/2013
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