Provider Demographics
NPI:1366054264
Name:KIBIGI ENTERRPRISES AND OIL LLC
Entity type:Organization
Organization Name:KIBIGI ENTERRPRISES AND OIL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BONIFACE
Authorized Official - Middle Name:
Authorized Official - Last Name:GITAU
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:316-791-7991
Mailing Address - Street 1:1148 S HILLSIDE ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67211-4006
Mailing Address - Country:US
Mailing Address - Phone:316-687-0006
Mailing Address - Fax:
Practice Address - Street 1:1148 S HILLSIDE ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67211-4006
Practice Address - Country:US
Practice Address - Phone:316-687-0006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-20
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health