KC Pharmacy Healthmart Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

0201004087 Issued in VA

Legal business name

KC PHARMACY HEALTHMART INC

Practice address

8988 Lorton Station Blvd
Suite 102
Lorton, VA 22079-4756

Phone

(703) 339-9599

Fax

(703) 339-7111

NPI assigned

Mar 23, 2012

Organization subpart

No

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

Authorized official

Name

Gihan SerakaNPI 1881982601

Title

Manager

Phone

(703) 339-9599

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• KC Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in VA, DC2 enrollments

Enrollment records 2

Tax ID family

KC Pharmacy Healthmart Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• KC Pharmacy Healthmart Inc

  • Specialty Pharmacy
  • Lorton, VA
  • NPI 1851901607
  NPD tax ID

Practitioners 1

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

• Gihan Seraka, RPH

  • Pharmacist
  • Lorton, VA
  • NPI 1881982601
  NPD Authorized official

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

{
    "created_epoch": "1332460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596672000000",
    "number": "1093081028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8988 LORTON STATION BLVD",
            "city": "LORTON",
            "state": "VA",
            "postal_code": "220794756",
            "telephone_number": "703-339-9599",
            "fax_number": "703-339-7111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8988 LORTON STATION BLVD",
            "address_2": "SUITE 102",
            "city": "LORTON",
            "state": "VA",
            "postal_code": "220794756",
            "telephone_number": "703-339-9599",
            "fax_number": "703-339-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KC PHARMACY HEALTHMART INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-23",
        "last_updated": "2020-08-06",
        "certification_date": "2020-08-06",
        "status": "A",
        "authorized_official_last_name": "SERAKA",
        "authorized_official_first_name": "GIHAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "703-339-9599"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "VA",
            "license": "0201004087",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093081028",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2134252",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KC Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "KC Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Heela Kakar
• Shaima Jalala Kanak, DNP,FNP
• Ofeliya Kara I
• Gurneet Kaur
• KC Medical Inc.
• KC Pharmacy Healthmart Inc
• KC Pharmacy LLC
• Metsihet L Kebede
• Angelynn G Keighin, BEHAVIOR TECHNICIAN
• Key Affinity Healthcare LLC

• Community/Retail Pharmacy in Lorton, VA
• Providers in Lorton, VA by specialty
• Community/Retail Pharmacy in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.