WEST KINGMAN PHARMACY, LLC (NPI# 1245357706) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1245357706 |
Entity Type | Organization |
Organization Name | WEST KINGMAN PHARMACY, LLC |
Practice Address |
3135 N Stockton Hill Rd Kingman AZ 86401 |
Mailing Address |
1099 Sunrise Ave Kingman AZ 86401-6825 |
Practice Telephone | 9283771350 |
Mailing Telephone | 9287184852 |
Mailing Fax Number | 9287184856 |
Enumeration Date | 2007-03-22 |
Last Update Date | 2020-03-11 |
Authorized Official Name | KASSIE LYNN VILLA (PHARMACY MANAGER) |
Authorized Official Telephone | 9283771350 |
Authorized Official Credential | CPHT |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
4696 | AZ | Suppliers |
Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
Suppliers |
Address | Telephone Number | Fax Number |
---|---|---|
3505 Western Ave, Kingman, AZ 864093011 | 9286815599 | 9287184856 |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | WEST KINGMAN PHARMACY, LLC | 3135 N Stockton Hill Rd, Kingman, AZ 86401-4165 |
Street Address |
3135 N STOCKTON HILL RD |
City | KINGMAN |
State | AZ |
Zip Code | 86401 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1760878821 | West Kingman Pharmacy LLC | Pharmacy | 3135 N Stockton Hill Rd, Kingman, AZ 86401 | 2015-04-15 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1053858704 | Robert Cole | Nurse Practitioner | 3545 Cheyenne Ave, King,an, AZ 86401 | 2017-01-19 |
1710420286 | Acadia Healthcare Inc | Nurse Practitioner | 2699 E Andy Devine, Suite B, Kingman, AZ 86401 | 2016-11-30 |
1174079800 | Kenneth Mcadow | Physical Therapist | 2404 Stockton Hill Road, Suite K, Kingman, AZ 86401 | 2016-09-01 |
1649659483 | Tracie Hirz | Case Manager/Care Coordinator | 3656 Packsaddle Road, Kingman, AZ 86401 | 2015-05-27 |
1548657695 | Chelsea Presbrey | Family Medicine | 2202 N Stockton Hill Rd Ste 100, Kingman, AZ 86401 | 2015-04-15 |
1649617226 | Abubakr Abdelmunim Tagelsir Abdelaziz | Internal Medicine | 2501 N Stockton Hill Rd Ste 102, Kingman, AZ 86401 | 2013-05-23 |
1205173325 | Patricia Jean Marko | Social Worker | 2002 Stockton Hill Road, Mohave Mental Health Clinic, Inc., Kingman, AZ 86401 | 2013-01-09 |
1770835316 | Hae Young Lee | Dentist | 2058 Maya Dr., Kingman, AZ 86401 | 2012-10-05 |
1255681623 | Hilary Radler | Specialist/Technologist | 3033 Macdonald, Kingman, AZ 86401 | 2012-09-13 |
1477836880 | Goodwill of Northern Arizona | Exclusive Provider Organization | 2369 Airway Avenue, Kingman, AZ 86401 | 2011-09-21 |
Find all providers in zip 86401 |
Taxonomy Code | 3336L0003X |
Grouping | Suppliers |
Classification | Pharmacy |
Specialization | Long Term Care Pharmacy |
A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. |
Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1043709785 | Kingman Drug Inc | Pharmacy | 211 N Main St, Kingman, KS 67068-1334 | 2018-05-08 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
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1912366774 | Pharmcare Usa of Greater Phoenix LLC | Pharmacy | 1835 S Alvernon Way Ste 202, Tucson, AZ 85711-5693 | 2016-02-22 |
1710388384 | Pharmacy Care Provider LLC | Pharmacy | 1135 N Jefferson Ave, Tucson, AZ 85712-5009 | 2014-09-15 |
1912312315 | East Valley Patient Care Services | Pharmacy | 218 W Hampton Ave, #4, Mesa, AZ 85210-5231 | 2014-06-24 |
1235565581 | Guardian Pharmacy of Tucson LLC | Pharmacy | 10900 N Stallard Pl, Oro Valley, AZ 85737-9544 | 2013-09-18 |
1972944221 | Genoa Healthcare, LLC | Pharmacy | 1500 S White Mountain Rd, Bldg 3, Suite 302, Show Low, AZ 85901-7929 | 2013-07-16 |
1730422601 | Genoa Healthcare, LLC | Pharmacy | 10240 N 31st Ave Ste 210, Phoenix, AZ 85051-9565 | 2013-03-29 |
1093067670 | Genoa Healthcare, LLC | Pharmacy | 15317 W Bell Rd Ste 106, Suite 106, Surprise, AZ 85374-3901 | 2012-10-08 |
Find all providers with the same taxonomy |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.