IKENNA CORPORATION (NPI# 1730244153) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730244153 |
| Entity Type | Organization |
| Organization Name | IKENNA CORPORATION |
| Other Organization Name | M J KELLY PHARMACY |
| Practice Address |
312 W 5th St Ste 103 Los Angeles CA 90013-1981 |
| Mailing Address |
312 W 5th St Ste 103 Los Angeles CA 90013-1900 |
| Practice Telephone | 2136225696 |
| Practice Fax Number | 2136225932 |
| Mailing Telephone | 2136225696 |
| Mailing Fax Number | 2136225932 |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2016-11-29 |
| Authorized Official Name | NWANMA IREGBULEM (PIC) |
| Authorized Official Telephone | 2136225696 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PHY47558 | CA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | PHY348190 | 05 | |
| PK | 2064879 | 01 |
| Other Name | Type Code |
|---|---|
| M J KELLY PHARMACY | Doing Business As Name - Organization |
| Street Address |
312 W 5TH ST STE 103 |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90013-1981 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013470327 | Mia Rashap | Technician, Other | 555 W 5th St, Los Angeles, CA 90013 | 2019-04-12 |
| 1992263941 | Shiane Lyana Ferretti | Technician, Other | 555 West 5th Street, Los Angeles, CA 90013 | 2019-03-08 |
| 1629567060 | Dtla Med | Clinic/Center | 431 S Hewitt St Ste B, Los Angeles, CA 90013 | 2018-05-01 |
| 1386150886 | Abel Joseph Apodaca Jr. | Counselor | 512 East 4th Street, Los Angeles, CA 90013 | 2017-12-19 |
| 1578075560 | Anthony Perez | Case Manager/Care Coordinator | 522 S San Pedro, Los Angeles, CA 90013 | 2017-10-30 |
| 1740724574 | Royalty Group Services Inc | Clinic/Center | 555 West Fifth Street 31st Floor, Los Angeles, CA 90013 | 2016-12-13 |
| 1275930877 | Araceli Zuniga | Rehabilitation Practitioner | 640 South Maple Avenue, Los Angeles, CA 90013 | 2014-11-25 |
| 1558785956 | Carlos Mejia | Counselor | 470 E. 3rd St., Los Angeles, CA 90013 | 2014-02-06 |
| 1679908081 | Troy Gabrielson | Counselor | 470 E. 3rd Street, Suite C, Los Angeles, CA 90013 | 2013-09-05 |
| 1417298753 | Pierre Houbein | Physician Assistant | 311 Winston St., Los Angeles, CA 90013 | 2013-03-12 |
| Find all providers in zip 90013 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| 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 |
|---|---|---|---|---|
| 1265040836 | Cmc Enterprise, Inc. | Pharmacy | 2426 W 8th St Ste 112, Los Angeles, CA 90057-3840 | 2020-07-20 |
| 1538782230 | Altamed Health Services Corp | Pharmacy | 3945 Whittier Blvd Rm 100, Los Angeles, CA 90023-2440 | 2020-05-28 |
| 1184243602 | Dtla Rx Pharmacy Apc | Pharmacy | 1120 S Grand Ave Ste 103, Los Angeles, CA 90015-4677 | 2020-04-14 |
| 1700405701 | Altamed Health Services Corp | Pharmacy | 972 Goodrich Blvd Rm 100, Los Angeles, CA 90022 | 2020-04-10 |
| 1649807140 | Mixlab, Inc. | Pharmacy | 2223 Federal Ave, Los Angeles, CA 90064-1403 | 2020-03-25 |
| 1457985426 | Care Prescription Management | Pharmacy | 5757 Wilshire Blvd Ste 320, Los Angeles, CA 90036-3686 | 2020-02-27 |
| 1609409077 | Altamed Health Services Corp | Pharmacy | 2100 W 3rd St Ste 190, Los Angeles, CA 90057-1999 | 2020-02-13 |
| 1003448184 | Linco Pharmacy, Inc. | Pharmacy | 5755 W Adams Blvd, Los Angeles, CA 90016-2440 | 2020-02-06 |
| 1972149292 | Cedars-sinai Medical Care Foundation | Pharmacy | 11800 Wilshire Blvd Ste 202, Los Angeles, CA 90025-6602 | 2019-11-21 |
| 1659930089 | Jade Kalelei Wilia | Pharmacy | 1411 N Mansfield Ave Apt 9, Los Angeles, CA 90028-7676 | 2019-06-10 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90013 |
Please comment or provide details below to improve the information on IKENNA CORPORATION.
| 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.