Kibble Enterprises Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY46583 Issued in CA

Legal business name

KIBBLE ENTERPRISES INC

Practice address

493 Main St
Quincy, CA 95971-9120

Phone

(530) 832-4218

Fax

(530) 832-1375

NPI assigned

Sep 30, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Michael Kibble, PHARM DNPI 1629194303

Title

Pharmacist Owner

Phone

(530) 283-0480

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• QUINCY DRUG STORE Doing business as

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael William Kibble, PHARM D

  • Pharmacist
  • Quincy, CA
  • NPI 1629194303
  NPD (past) Authorized official
• Mary Therese Pearson, R. PH

  • Pharmacist
  • Quincy, CA
  • NPI 1629194345
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458604800000",
    "number": "1083601496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "157 COMMERCIAL ST",
            "city": "PORTOLA",
            "state": "CA",
            "postal_code": "961229606",
            "telephone_number": "530-832-4218",
            "fax_number": "530-283-1410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "493 MAIN ST",
            "city": "QUINCY",
            "state": "CA",
            "postal_code": "959719120",
            "telephone_number": "530-832-4218",
            "fax_number": "530-832-1375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIBBLE ENTERPRISES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-30",
        "last_updated": "2016-03-22",
        "status": "A",
        "authorized_official_last_name": "KIBBLE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PHARMACIST OWNER",
        "authorized_official_telephone_number": "530-283-0480",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY46583",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2076757",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA465830",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "QUINCY DRUG STORE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Steen W. Jensen, MD FACS
• Richard K Johnston
• Tiffany Jones-Burson
• Tristan Kadish
• Jeffrey G Kepple, MD
• Michael William Kibble, PHARM D
• Kinne Marriage and Family Therapy, Inc.
• Allison Makena Kinne, LMFT
• Mary Christine Knox
• Kory P Felker

• Community/Retail Pharmacy in Quincy, CA
• Providers in Quincy, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.